Tinnitus disappears when a cochlear implant is inserted into the ear. This is indicated by study results. However, this only affects people who were deaf and therefore received a cochlear implant. For tinnitus patients with normal hearing this is not yet a solution.
Tobias Kleinjung in conversation with Arndt Reuning
Patient with hearing implant (picture alliance / dpa / Birgit Reichert)
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Arndt Reuning: A cochlear implant is a hearing aid for almost deaf people in whom the fine hair cells, the sensory cells in the inner ear, have died but the auditory nerve is still functioning. The prosthesis picks up sound waves using a microphone. These signals are then transmitted to a fine electrode that stimulates the auditory nerve. It can restore hearing within certain limits, but it can obviously do even more: it can suppress tinnitus noises. This was the topic of a tinnitus conference that ended on Friday in Regensburg. Tobias Kleinjung, professor at the University Hospital of Zurich, spoke about it. Before the broadcast, I wanted to know from him what the details were about.
Tobias Kleinjung: In the end, it is about the fact that it has been observed that patients who have had a cochlear implant inserted have had an improvement in their tinnitus perception due to deafness in one or both ears. This is something that has been observed for a long time and is now becoming more and more important, especially in the area of so-called unilateral deafness.
Reuning: Does this mean that a cochlear implant would only be suitable as a therapeutic approach for such patients?
People with tinnitus were implanted for a study
Little boy: Exactly. The prerequisite for receiving a cochlear implant is an ear that is so poorly hearing or deaf that it can no longer be fitted with a conventional hearing aid. This is a well-known routine operation that has certainly been carried out for 30 years, but which has mainly been used when both ears have heard nothing and then the ability to communicate has been completely lost.
In the situation of one-sided deafness, however, one still has a good ear, with which one can get by at least to some extent, but on the deaf ear often a very unpleasant ear noise. And it was originally thought that a combination of normal hearing on one side and electronic hearing on the other would not work.
Ten years ago, colleagues in Antwerp, Belgium, started a study in which they implanted deaf people on one side of their deaf ear mainly because of their tinnitus problems. It was very fascinating to see how after the activation of the implant the noise in the ears was partly completely suppressed or strongly suppressed and at the same time the hearing improved.
Reuning: This very special group of patients who are even considered for this therapy option, how does it compare to conventional therapies, namely cognitive behavioral therapy?
Kleinjung: Interestingly enough, the benefit that these patients have when using conventional measuring instruments such as questionnaires or visual analogue scales is usually much greater than can be achieved with conventional therapy methods. This is certainly also due to the fact that with this procedure, at least during the time when the implant is activated, a high percentage, I would say about half of all patients achieve complete suppression of ear noise. And accordingly the questionnaire values or the visual analogue scales improve many times more than you can achieve with conventional means.
“You’d have to design a special tinnitus electrode.”
Reuning: Would a cochlear implant be a therapeutic option for people who otherwise have a healthy hearing?
Kleinjung: Not in its current form, of course, because a cochlear implant is surgically inserted into the cochlea. And if we have a healthy ear and then insert this electrode into the cochlea, we destroy large parts of the healthy hearing, so to speak. This means that it certainly doesn’t make sense in this form, but there is research that uses an extremely short electrode, for example only in the area of the round window, to stimulate and improve tinnitus symptoms. In other words, one would then have to design a special tinnitus electrode in the routine, so to speak, which does not destroy the normal hearing, the existing hearing.
Reuning: How far away are such instruments from clinical routine?
Kleinjung: Such devices exist so far only in clinical studies. A few years ago, there was a study where a corresponding implant was placed on the round window membrane and applied to patients with normal hearing and where there was also an improvement in ear noise complaints. However, these studies and these companies have changed in the meantime. And so far, I believe, we are still a whole step away from the fact that there will be a specific tinnitus electrode, for example in the sense of permanent electroacoustic stimulation.
Statements made by our interlocutors reflect their own views. Deutschlandfunk does not adopt statements made by its interlocutors in interviews and discussions as its own.