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Author: admin, 02.03.2015. Category: Is There A Cure For Tinnitus

How to cite this article Mendes RCCG, Ribas A, Macedo IP, Buschle M, Ataide AL, Pereira R, Kochen AP, et al. Several studies have shown that cochlear implants may reduce or even eliminate tinnitus in patients with bilateral profound hearing loss. Keywords: cochlear implants, deafness, language and hearing sciences, speech, speech perception, tinnitus. Tinnitus means perceiving a sound that is not being generated in the environment at that time. Considered one of the most common symptoms of profound sensorineural hearing loss, tinnitus can significantly affect the quality of life of individuals2.
The latest international publications7,8 suggest that patients with unilateral hearing loss, or even severe hearing loss, presenting ipsilateral tinnitus with hearing loss, unresponsive to several treatments, may also benefit from electrical stimulation of the auditory nerve through the CI. The beneficial effect of a CI on tinnitus can be explained by acoustic masking, by electrical stimulation directly to the auditory nerve, and especially by the reorganization of the central auditory system and associative brain areas that occurs after activation of the implant. The aim of this study was to describe the audiological results of a patient with asymmetric hearing loss with ipsilateral disabling tinnitus, who was underwent the CI procedure. Throughout the ENT care, various treatments were performed without success, for the reduction or remission of tinnitus, which led the patient at the time to have suicidal thoughts. The patient underwent cochlear implant surgery to the right ear in an attempt to improve auditory acuity, but mainly as a last resort in tinnitus treatment. Before the CI, results were compatible with profound hearing loss to the right ear and severe loss to the left. After the CI, thresholds compatible with normal hearing on the right ear were observed, as shown in Figure 1. We used the Glendonald Auditory Screening Procedure (GASP test)12 which classifies the category of hearing on a scale of zero to six, where zero means no detection of speech sounds and six means open-set speech recognition. The protocol for assessing tinnitus was applied at the following times: before surgery, 45 days after surgery (activation of CI), two months later, six months later and one year after CI surgery. The literature11 states that the CI is configured as an alternative treatment of deafness and constitutes a multifactorial process with proven effectiveness. The Brazilian study17 indicates that the hearing assessment obtained six months after the first implant programming demonstrates that English-speaking patients get excellent results in tests of recognizing words and sentences in open presentation, regaining useful hearing. Despite these satisfactory and known findings by physicians and audiologists, the primary complaint by the subject, which is the focus of this study, was the tinnitus.
Di Nardo et al.6 reported that the CI provides effective results in reducing the perception of tinnitus intensity. Statistically significant reduction in THI overall indices and sub-indices, pre and post CI, were demonstrated in scientific studies8,11 showing lower levels of discomfort and a decrease in the intensity of tinnitus as a result of direct electrical stimulation of the auditory nerve and reorganization of the central auditory pathways and cortical association areas, leading to the use of tinnitus as a criterion for choosing the ear to be implanted.
The results related to the concentration (66%), emotional (100%), sleep (26%) and hearing (96%) obtained by preoperative TAQ converged at a rate of 72% indicating strong interference of tinnitus, especially in the emotional and hearing states of the patient. Factor 3, life prospects, went from a preoperative score of 100% to 50% after activation of the CI, 25% after two months of use, 75% after six months and reduction to 25% after 1 year of CI use. The consulted study11 shows that the CI generates maximum benefit in remission buzz around seven months after the performed procedure.


The reduction in the intensity and degree of tinnitus annoyance confirms the improvement in the quality of life of individuals, a fact that must be considered in preoperative counseling of patients with tinnitus as candidates for cochlear implants. CI as a treatment for post-lingual profound hearing loss is highly effective, there is improvement seen in hearing thresholds in performance and perception of speech sounds, as in the case presented. Although the literature describes the indication of CI for patients with tinnitus, the initiative is still not being widely accepted by physicians and speech-language pathologists, especially when hearing loss is unilateral or asymmetric.
Paper submitted to the ITJ-SGP (Publishing Management System) on May 21, 2013; and accepted on June 21, 2013. If you suspect that you have a hearing loss or are experiencing any of the difficulties mentioned in the previous section, it is important that you have your hearing tested. All results will be discussed in detail with you and if you do have a hearing loss, your audiologist will explain whether hearing aids will be of benefit to you.
However, there are not consistent references regarding ipsilateral tinnitus compared to unilateral profound hearing loss.
It is a very frequent symptom, which may affect around 17% of the population in some countries. Several studies claim that the cochlear implant (CI) can diminish or even eliminate the perception of tinnitus in patients with bilateral profound hearing loss and that, although a risk of tinnitus perception that increases after implantation exists, it is very small3-6.
With the support of these findings researchers suggest that tinnitus should be a selection criterion in choosing which ear to implant and that patients with severe unilateral hearing loss associated with severe tinnitus can be considered CI candidates9-11.
The comparison between the responses obtained before and after the CI verify the benefits achieved with this therapy. The tests were conducted in a soundproof booth, with the Madsen Itera - GN Otometrics audiometer.
The test was applied prior to the CI, five months later, eight months later, and finally, after a year.
This fact was borne out in this case report, where the pre and postsurgical audiometric tests showed improvement in tone thresholds with CI use. In this study, by applying the VAS, we observed a significant reduction in the intensity of tinnitus perception, and that after activation of the CI, the rating went from four to one after 60 days of using the device. In our study, after activation of the CI, there was a reduction in the THI total index (six) and sub-indices (functional 2, catastrophic 0, and emotional 4) to a score of one. A total reduction of assessed scores on aspects of sleep and concentration with a reduction of greater than 20%, significant data regarding the emotional and hearing aspects, was observed after activation of the CI.
In our study there was a significant reduction in the percentage of THQ (Table 3) after activation of the CI and the subsequent evaluations (two and six months of CI use) mainly in factors 1 and 2. In addition, it can be seen that the CI was critical to the reduction of tinnitus perception. Speech, Language and Hearing Sciences - Universidade Tuiuti do Parana - Curitiba - PR - Brasil.
Department of Otolaryngology - Hospital Infantil Pequeno Principe - Curitiba - PR - Brasil. Speech, Language and Hearing Sciences - Hospital Infantil Pequeno Principe - Curitiba - PR - Brasil.


You will be seen by an audiologist who will discuss your concerns with you and perform the necessary hearing tests to evaluate your hearing.
Should you decide to go this route, your audiologist will work with you to determine which hearing aid will be the most suitable for your hearing loss and lifestyle. The aim of this paper is to describe audiological results of a patient with asymmetrical hearing loss with incapacitating ipsilateral tinnitus in the ear subjected to cochlear implant surgery. We do not know its prevalence in Brazil, but if we extrapolate the data from our international population, it is possible that some 28 million Brazilians have already had some form of tinnitus1. Chart 1 shows the comparison between the results where it can be verified that the patient progressed from category zero to six in the 12-month study.
The patient went from category zero to six, where there is open-set recognition of words and phrases together.
The degree of discomfort, intolerance or failure often are not related to the intensity of tinnitus, says a consulted study1, but mood disorders (depression, dysthymia) and anxiety often present, exerting strong influences on the worsening of the tinnitus.
After 180 days of use, the patient did not perceive any ringing with the CI turned on and noticed only mild tinnitus with the CI off.
Influence of evoked compound action potential on speech perception in cochlear implant users.
Incapacitating unilateral tinnitus in single-sided deafness treated by cochlear implantation. Stimulation by cochlear implant in unilaterally deaf rats reverses the decrease of inhibitory transmission in the inferior colliculus. Techniques for assessing auditory speech perception and lipreading enhancement in young deaf children.
Resultados auditivos com o implante coclear multicanal em pacientes submetidos a cirurgia no Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo.
She may also provide counseling to your family members to show them how to communicate more effectively with you. Audiological exams and responses to perception protocols for tinnitus before and after surgery were analyzed. Without a personal sound amplification device (PSAP) during the application of the GASP, the patient reported that he felt only a slight vibration in the right ear to the presented sound stimuli. In our study, the patient reported he had considered suicide due to the discomfort caused by tinnitus. Experiencia do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo. The tests showed improvements in the hearing threshold on the side with the implant, improvements in speech perception and a significant reduction in tinnitus perception, which consequently led to an improvement in the patient's quality of life. Shortly after activation of the CI he began to recognize open-set word and auditory performance, improving at each evaluation.



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