Tinnitus in cochlear implantees: cognitive behavioural therapy for cochlear implant users

Abstract

Background to the study: Cochlear implants (CI) can help to suppress tinnitus and often make existing tinnitus more bearable. However, a number of patients still suffer from tinnitus afterwards. In some cases the implantation makes existing tinnitus worse, or tinnitus may occur as a result of cochlear implantation. Because of the inconclusive aetiology of tinnitus it is difficult to treat its effects. So far, one of the most popular treatments for tinnitus is the widely used Cognitive Behavioural Therapy (CBT), which aims to influence dysfunctional emotions, behaviours and cognitions though a goal-orientated, systematic procedure. CBT aims to minimize the side-effects of tinnitus and help to manage it in a more efficient way. CBT has been investigated in several studies and shows promising results in reducing the debilitating effect of tinnitus. CBT has not yet been used specifically for, or investigated in, relation to treating CI users suffering from tinnitus.

Aims and outline of the study: Our research aimed to investigate CBT’s effectiveness for cochlear implant users. Using a randomized control trial, we investigated whether two-hour Tinnitus Workshops for the control group were as equally as effective as CBT for the research group. We also explored if either type of treatment for cochlear implant users needed any modifications to make them more suitable for this group of tinnitus sufferers. Using Open Questions, we investigated tinnitus in cochlear implant users. We analysed the Open Questions from both groups, creating a profile of a typical cochlear implant user who suffers from tinnitus, and we also explored whether both interventions (Tinnitus Workshop or CBT) were suitable for this kind of patient. Data was gathered, pre- and post-interventions, by questionnaires; these were Tinnitus Questionnaires (TQ), Visual Analogue Scale (VAS), Quality of Life Short Form 36 Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS).

Results: In the control group, we found no significant differences between the TQ scores pre- and post-intervention. VAS scores post-intervention were lower than pre-intervention, indicating some improvement in individual tinnitus perception; however, the difference was not significant. In the research group, we found small, but not significant, differences in both TQ pre- and post-intervention (z =1.83, p>.05) and in VAS (z=0.14, p>.05). No significant differences were found between the control and the research group pre- and post-intervention.

Conclusions: The questionnaires used in this study, such as TQ or VAS, showed a decrease in general tinnitus distress, but a larger-sized sample group may be needed for greater statistical certainty. The results from the Open Questions showed that cochlear implant users were affected by tinnitus in a similar way to non-cochlear implant users. Overall, both interventions need further, small modifications and adjustments to their protocols in order to be more effective for this type of tinnitus sufferer.

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Identifiers

ORCID for S. Bleeck: orcid.org/0000-0003-4378-3394

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