Tags

Type your tag names separated by a space and hit enter

Non-penetrating round window electrode stimulation for tinnitus therapy followed by cochlear implantation.
Eur Arch Otorhinolaryngol. 2015 Nov; 272(11):3283-93.EA

Abstract

One main theory behind the origin of tinnitus is based on the idea that alterations of the spontaneous electrical activity within the auditory system lead to abnormal firing patterns in the affected nervous structures [1]. A possible therapeutic option is the use of electrical stimulation of the auditory nerve for the recovery or at least limitation of the abnormal firing pattern to a level that can be easily tolerated by the patient. The Tinnelec Implant consists of a single non-penetrating stimulation electrode connected to a Neurelec cochlear implant system. As a first feasibility study, before starting implantations in hearing patients, we thought to assess the potential of the Tinnelec stimulation to treat tinnitus in unilateral deaf patients, analysing hereby its effectivity and risks. Three patients suffering from unilateral tinnitus resistant to pharmacological treatment and ipsilateral severe to profound sensorineural hearing loss/deafness were implanted with a Tinnelec system between September 2007 and July 2008, at the ENT Department of Hannover Medical School. The stimulation strategy was chosen to induce alleviation of the tinnitus through suppression, masking and/or habituation and the response of each patient on the treatment was monitored using a visual analogue scale (VAS) on loudness and annoyance of tinnitus, mood of the patient, as well as the tinnitus handicap inventory (THI). All patients had a benefit from the electrical stimulation for their tinnitus (THI-score improvement of 20-70), however, not all participants profited from the Tinnelec system in same way and degree. In one patient, despite good results, the device had to be replaced with a conventional cochlear implant because of Tinnelec-independent increase in hearing loss on the contralateral ear. Additionally, due to the extension of cochlear implant indications, the devices of the other two patients have been meanwhile replaced with a conventional cochlear implant to benefit additionally from hearing improvement. As demonstrated in the present study, sensorineural tinnitus in humans may be suppressed/masked/habituated by electrical stimulation. The main advantage of the Tinnelec implant would be the option to treat patients with normal and usable hearing, stimulating the affected ear with the cochlear non-penetrating stimulation electrode of the device, and extend the treatment in cases of progressive hearing loss by explanation and reimplantation with a penetrating electrode addressing tinnitus as well as the hearing impairment. The present study is the first report on a long-term follow-up on tinnitus patients implanted with Tinnelec. Further clinical studies to implant tinnitus patients with residual or normal hearing on the affected ear are on the way.

Authors+Show Affiliations

Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany. gentiana.wenzel@uks.eu. Department of Otorhinolaryngolology, Saarland University Medical Center Germany, Geb. 6, Kirrberger Straβe, Homburg/Saar, 66421, Germay. gentiana.wenzel@uks.eu.Oticon Medical/Neurelec GmbH, Auf dem Schmaarkamp 1a, 21339, Lüneburg, Germany.Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Department of Otorhinolaryngology, University Hospital, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.Department of Psychosomatic and Psychotherapy, Medical University Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25480476

Citation

Wenzel, Gentiana I., et al. "Non-penetrating Round Window Electrode Stimulation for Tinnitus Therapy Followed By Cochlear Implantation." European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, vol. 272, no. 11, 2015, pp. 3283-93.
Wenzel GI, Sarnes P, Warnecke A, et al. Non-penetrating round window electrode stimulation for tinnitus therapy followed by cochlear implantation. Eur Arch Otorhinolaryngol. 2015;272(11):3283-93.
Wenzel, G. I., Sarnes, P., Warnecke, A., Stöver, T., Jäger, B., Lesinski-Schiedat, A., & Lenarz, T. (2015). Non-penetrating round window electrode stimulation for tinnitus therapy followed by cochlear implantation. European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 272(11), 3283-93. https://doi.org/10.1007/s00405-014-3413-8
Wenzel GI, et al. Non-penetrating Round Window Electrode Stimulation for Tinnitus Therapy Followed By Cochlear Implantation. Eur Arch Otorhinolaryngol. 2015;272(11):3283-93. PubMed PMID: 25480476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-penetrating round window electrode stimulation for tinnitus therapy followed by cochlear implantation. AU - Wenzel,Gentiana I, AU - Sarnes,Petra, AU - Warnecke,Athanasia, AU - Stöver,Timo, AU - Jäger,Burkard, AU - Lesinski-Schiedat,Anke, AU - Lenarz,Thomas, Y1 - 2014/12/06/ PY - 2014/06/17/received PY - 2014/11/26/accepted PY - 2014/12/7/entrez PY - 2014/12/7/pubmed PY - 2016/5/11/medline KW - Electrical stimulation KW - Non-penetrating cochlear electrode KW - Round window KW - Tinnelec KW - Tinnitus SP - 3283 EP - 93 JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery JO - Eur Arch Otorhinolaryngol VL - 272 IS - 11 N2 - One main theory behind the origin of tinnitus is based on the idea that alterations of the spontaneous electrical activity within the auditory system lead to abnormal firing patterns in the affected nervous structures [1]. A possible therapeutic option is the use of electrical stimulation of the auditory nerve for the recovery or at least limitation of the abnormal firing pattern to a level that can be easily tolerated by the patient. The Tinnelec Implant consists of a single non-penetrating stimulation electrode connected to a Neurelec cochlear implant system. As a first feasibility study, before starting implantations in hearing patients, we thought to assess the potential of the Tinnelec stimulation to treat tinnitus in unilateral deaf patients, analysing hereby its effectivity and risks. Three patients suffering from unilateral tinnitus resistant to pharmacological treatment and ipsilateral severe to profound sensorineural hearing loss/deafness were implanted with a Tinnelec system between September 2007 and July 2008, at the ENT Department of Hannover Medical School. The stimulation strategy was chosen to induce alleviation of the tinnitus through suppression, masking and/or habituation and the response of each patient on the treatment was monitored using a visual analogue scale (VAS) on loudness and annoyance of tinnitus, mood of the patient, as well as the tinnitus handicap inventory (THI). All patients had a benefit from the electrical stimulation for their tinnitus (THI-score improvement of 20-70), however, not all participants profited from the Tinnelec system in same way and degree. In one patient, despite good results, the device had to be replaced with a conventional cochlear implant because of Tinnelec-independent increase in hearing loss on the contralateral ear. Additionally, due to the extension of cochlear implant indications, the devices of the other two patients have been meanwhile replaced with a conventional cochlear implant to benefit additionally from hearing improvement. As demonstrated in the present study, sensorineural tinnitus in humans may be suppressed/masked/habituated by electrical stimulation. The main advantage of the Tinnelec implant would be the option to treat patients with normal and usable hearing, stimulating the affected ear with the cochlear non-penetrating stimulation electrode of the device, and extend the treatment in cases of progressive hearing loss by explanation and reimplantation with a penetrating electrode addressing tinnitus as well as the hearing impairment. The present study is the first report on a long-term follow-up on tinnitus patients implanted with Tinnelec. Further clinical studies to implant tinnitus patients with residual or normal hearing on the affected ear are on the way. SN - 1434-4726 UR - https://www.unboundmedicine.com/medline/citation/25480476/Non_penetrating_round_window_electrode_stimulation_for_tinnitus_therapy_followed_by_cochlear_implantation_ L2 - https://dx.doi.org/10.1007/s00405-014-3413-8 DB - PRIME DP - Unbound Medicine ER -