Effects of Tinnitus on Cochlear Implant Programming.
Robert H Pierzycki, Charlotte Corner, Claire A Fielden and 1 others
PMID 30880643WHAT IT FOUND
Tinnitus mostly disrupted cochlear implant programming when setting lower-level sounds.
Patients confused test sounds with tinnitus, and lower-level settings were 1.7 dB higher in tinnitus users. Upper-level settings and the range between them did not differ.
Key findings
01Threshold levels were higher by 1.7 dB in patients with tinnitus than in patients without tinnitus.
02Nearly all audiologists (88% to 94%) said tinnitus made programming more difficult, but only 28% to 30% of patients with tinnitus agreed.
03Almost all audiologists (95%) used specific strategies, most commonly varying or counting stimulus presentations.
STILL TO COME
How it was doneWhat they found
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What it does not show
Only six audiologists were interviewed, so the themes may not reflect all cochlear implant programming practices. The audiologist survey included 20 audiologists from 9 centers, representing 50% of adult cochlear implant services in the United Kingdom. Only 128 adult cochlear implant recipients from one centre responded to the postal survey, which the paper states was 20% of those invited. The programming parameter comparison used only 20 patients, only Cochlear Ltd devices, and only first activation appointments, so it may not apply to other manufacturers or later appointments. Patients whose tinnitus started after activation were excluded from the programming analysis. The study did not measure speech perception or follow programming changes over time. Cochlear implant programming procedures are not standardized, and strategies may vary by manufacturer and clinician.
Declared interests
The supplied text lists Nottingham Hospitals Charity as the funder.
The easy way to misread this
Do not read the 1.7 dB higher threshold finding as proof that tinnitus causes worse speech outcomes. The study did not measure speech perception, and comfortable levels and dynamic range did not differ significantly.