Long-Term Evaluaon of Cochlear Implantaon in Subjects with ... · Mertens G, De Bodt M, Van de...

Long-TermEvalua0onofCochlearImplanta0oninSubjectswithAcquiredUnilateralHearingLoss

andincapacita0ng0nnitusupto10YearsFocusonTinnitusOutcomes

PaulVandeHeyning,MD,PhDGrietMertens,PhD

Relevantfinancialrela0onshipswithcommercialinterests

thatpertaintothecontentofthispresenta0on:

Company:

GrantMED-EL(Innsbruck,Austria)andCOCHLEARpaidtotheins0tu0on

UZA.

TinnitusSubjects TAnnoyance Conclusion

Experimentalset-up• 30acquiredSSD/AHL&incapacita0ng0nnitus*;VAS>6/10

§  Dura0on>2yearand<10years§  IrresponsivetodrugsorTRT/CBT§  19ptwithSSD§  11ptwithAHL§  CIwithcompleteelectrodeinser0on(MED-EL)§  Regularficng4weeksaeerCI

• 7ptSSDwithprogressiveelectrodeac0va0onofCI• 3EAS• 1ABI• 2withmajordepression



Inclusioncriteria Exclusioncriteria

- SSD/AHLwithTinnitus- Severe0nnitus:0nnitusloudness6-10onVASfor>6months

- Majordepression- Notwillingtoahendrehabilita0onandfollow-up

- Subjec0ve0nnitusduetoipsilateralprofoundSNHLorpar0aldeafness

Othertypesof0nnitus- Standardtreatmentsof0nnitushavenoeffect Dura0onofdeafness>10years?

-Realis0cexpecta0ons

-Normalhearingtomoderatehearingloss

contralaterally(AHL)

-PatentScalatympani

Subjects Tinnitus TAnnoyance Conclusion

ControlCIoffCIon

-12-24mnths


KleinePuntAetalCII2011;Suppl1:S26-9&HearRes2013;295:24-9.

Tinnituscharacteris0cs

• Nodifferencebetweenpuretonetype0nnitusnoisetype0nnituspolyphonicsensa0on

• NodifferencebetweenLowpitchMidpitchHighpitch

• Nodifferenceofdura0onofdeafness&0nnitus

Subjects Tinnitus TAnnoyance Conclusion!!

!!!!Figure 4. Scores of the Visual Analogue Scale (VAS) for assessing tinnitus loudness, pre-

operatively, 1, 3, 6, 12, 36 months post-operatively and at the Long-term test-interval. White bars

represent the CIOFF condition (�) and grey bars the CION condition (�).Significant differences (p<

0.01) are indicated with an asterisk (**).

0

1

2

3

4

5

6

7

8

9

10

pre-op 1M 3M 6M 1Y (3Y) LT LT_OFF

** ** **

VandeHeyningPetal.AnnOtolRhinolLaryngol2008;117:645-652MertensG,DeBodtM,VandeHeyningP.HearRes.2016Jan;331:1-6.


012345678910VA

S6nn

itus_loud

ness



-10

-8

-6

-4

-2

0

2

SpeechRecep

0onThreshold(dB

SNR)

UnaidedAided0nnitustestcondi0oncontrolcondi0on

ThemeandifferenceinSRTinthenon-0nnitusearbetweenthetwocondi0ons(SRTCIoff-SRTCIon)=1,98dBSNR(SD3,01dBSNR)

MertensG.,KleinePunteA,VandeHeyningPOtolNeurotol2013;34(4):662-6

ContralateralSpe

echPe

rcep

6on



TQTinnitusQues0onnaire

Lowerisbeher

Subjects Tinnitus TAnnoyance Conclusion!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Figure 6. Median Tinnitus Questionnaire scores for the A_SSD Group and for the B_AHL Group, including the individual

subscale scores; emotional distress, cognitive distress, auditory perceptual difficulties, intrusiveness, sleep disturbance,

and physical complaints. Dark bars (!) indicate pre-operative scores and light bars (!) indicate long-term scores.

Significant differences between both test moments are indicated with an asterisk (*).

TOTAL TQ SCORE Emo. Cogn. Aud. Intr. Sleep. Soma.

0

10

20

30

40

50

60

70

80

0%

20%

40%

60%

80%

100%

0%

20%

40%

60%

80%

100%

0

10

20

30

40

50

60

70

80

TQ s

core

TQ

sco

re

A_SSD

B_AHL

** ** * * * **

* * * *

TQTinnitusQues0onnaire

Lowerisbeher



MertensG,DeBodtM,VandeHeyningP.HearRes.2016Jan;331:1-6.

!

!!!!!Figure 7. Median scores of the Hyperacusis Questionnaire for the A_SSD Group and for the B_AHL Group. Total scores and

the three subscales: Attention, Social and Emotional are shown. Two conditions were surveyed; the CION condition (!) and the

CIOFF condition (!). Significant differences between the CION and the CIOFF condition are indicated with an asterisk (*).

0

10

20

30

40

50

0

10

20

30

40

50

Total Score Attention Social Emotional

A_SSD_Group

B_AHL_Group

Tot

al S

core

T

otal

Sco

re

* * *

HyperacusisQ(Khalfi)

Subjects Tinnitus SoundLocaliza0on Conclusion0 5 10 15 20

7 days a week

5h / day CI Switch-on = first act when rising; CI Switch-off last act before bedtime

Noise Polyphone Pure Tone

≤1 min. >1 - ≤10 min.

When start concentrating

≤1 min. >1 - ≤10 min.

When stop concentrating

Revealed from tinnitus

Tinnitus as primary advantage of CI Hearing as primary advantage of CI

Tinnitus as primary advantage of CI Hearing as primary advantage of CI

!

!

CI

Use

(n

=23)

!

Tin

nitu

s

(n=2

3)

Type of tinnitus

!

Tinnitus starts

decreasing

!

Tinnitus starts to

return!

!

!

AH

L

SSD

(n

= 11

) (

n= 1

2) !

MertensG,DeBodtM,VandeHeyningP.HearRes.2016Jan;331:1-6.


Cochlearimplanta6oninUnilateralHearingLossSeeMertensS12at3.45PM

ü  Improvedhearingcapabili0es-Speechpercep0oninnoise

-Soundlocaliza0on

ü  Decreasingthe0nnitusloudnessanddistress

Unilateralhearinglossandincapacita6ng6nnitusisanewindica6onforCI.

ProgramdirectorsGrietMertensPhDAnoukHosensMaAudAnnickGillesPhDAnBoudewynsMDPhDOlivierVandervekenMDPhDConferenceOrganisa6onSemicoVenueIntFlandersConferenceCenterAntwerpDowntown

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Long-Term Evaluaon of Cochlear Implantaon in Subjects with ... · Mertens G, De Bodt M, Van de...

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