randomized controlled study that modified TRT appears to offer a new intervention for improving sound tolerance in the general hearing-impaired population, allowing persons with reduced tolerance or limited dynamic ranges to use hearing aids more effectively (Supported by NIH R01 DC04678).
Optimizing Electric Stimulation to Suppress Tinnitus. (Abstract of ARO Meeting Denver, Colorado) Fan-Gang Zeng1, Qing Tang1, Jeff Carroll1, Andrew Dimitrijevic1, Arnold Starr1, Leonid Litvak2, Jan- nine Larky3, Nikolas Blevins3 1Unversity of California Irvine, 2Advanced Bionics Corporation, 3Stanford University
Here we reported psychophysical, electrophysiological, and clinical results from a unique subject, CINH001, who received a Clarion HiRes90k cochlear implant to control debilitating tinnitus in his right ear. CINH001 had essentially normal hearing in his left ear, so that he could match both tinnitus and electric stimulation in the right ear to acoustic stimulation in the left ear. CINH001 matched his tinnitus to an acoustic stimulus of 4000-8000 Hz and at 70-90 dB SPL. The effect of electric stimulation on tinnitus was evaluated as a function of pulse rate from 25 to 5000 Hz, pulse duration from 10 to 500 uS per pha- se, electrode position from apex to base, and stimulation configuration from monopolar to bipolar mode. Different from previous studies showing a suppressive effect of high-rate stimulation on tinnitus, only stimuli with low rates (40-100 Hz), short pulse duration, the most apical electrode, and monopolar mode could suppress his tinnitus. Objective measures in both spontaneous and event-related evoked poten- tials also showed a difference related to the presence and absence of tinnitus. An innovative acoustic waveform employing a Gaussian-enveloped sinusoid and optimized programming of electric parameters allowed CINH001 to use his behind-the-ear processor to suppress tinnitus effectively at home. These results underscore the need to customize electric stimulation for tinnitus suppression and suggest that complementary stimulation, rather than masking, is the brain mechanism underlying the present surpri- sing finding (Supported by NIH RO1 DC002267).
Tinnitus and cochlear implantation in adults - a retrospective study. (Abstract of ARO Meeting Denver, Colorado) Esma Idrizbegovic1, Anders Freijd2, Eva Karltorp2, Gerhard Andersson3 1Department of Audiology, Karolinska University Hospital, Stockholm, Sweden, 2Department of ENT, sec- tion for Cochlea Implant, Karolinska University Hospital, Huddinge, Sweden, 3Department of Behavioural Sciences, Linköping University, Sweden
Few studies have outlined the temporal association between cochlear implantation and tinnitus onset or changes. The aim of the study was to use validated self-report measures in a consecutive sample of cochlea implant (CI)- patients who reported tinnitus. Methods: A total of 151 (83% response rate) responded to postal questionnaires, and of these 111 re- ported that they had tinnitus. Questions regarding tinnitus in relation to CI and the operation were asked. In addition, three established selfreport questionnaires were included measuring tinnitus handicap, hea- ring disability and handicap and finally a measure of anxiety and depression. Results showed that few patients had permanently worsened tinnitus or got tinnitus following cochlear implantation. However, a fifth did report that their tinnitus was worsened. As many as 25 patients repor- ted that their tinnitus completely disappeared when the processor was turned on and that it returned when the processor was turned off again. Only 4 patients reported that their tinnitus increased when the processor was turned on. A common response (N=31) was that tinnitus was unchanged following the CI operation. Data from established questionnaires showed relatively low levels of tinnitus handicap, mode- rate levels of hearing disability and handicap, and low scores on the anxiety and depression scales.
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