Changes in Tinnitus After Middle Ear Implant Surgery: Comparisons With the Cochlear Implant

OBJECTIVES: Tinnitus is a very common symptom in patients with hearing loss. Several studies have confirmed that hearing restoration using hearing aids or cochlear implants (CIs) has a suppressive effect on tinnitus in users. The aim of this study was to analyze the effect of other hearing restoration devices, specifically the middle ear implant (MEI), on changes in tinnitus severity. DESIGN: From 2012 to October 2014, 11 adults with tinnitus and hearing loss underwent MEI surgery. Pure-tone audiometry, tinnitus handicap inventory (THI), and visual analog scale scores for loudness, awareness, and annoyance and psychosocial instruments were measured before, immediately after, and 6 months after surgery. Changes in hearing thresholds and THI scores were analyzed and compared with those of 16 CI recipients. RESULTS: In both MEI and CI groups, significant improvements in tinnitus were found after the surgery. The THI scores improved in 91% of patients in the MEI group and in 56% of those in the CI group. Visual analog scale scores and psychosocial scale scores also decreased after surgery, but there were no statistical differences between the groups. CONCLUSIONS: The results indicate that the MEI may be as beneficial as the CI in relieving tinnitus in subjects with unilateral tinnitus accompanying hearing loss. Furthermore, this improvement may manifest as hearing restoration or habituation rather than a direct electrical nerve stimulation, which was previously considered as the main mechanism underlying tinnitus suppression by auditory implants.ope