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Systematic review of cochlear implantation and tinnitus
Ahmad N. , Taljaard D. , Atlas M.
Ear Science Institute Australia, Subiaco, Australia
Objective: The objective of this study was to systematically review both the quality of the evidence and tinnitus
outcomes following cochlear implantation (CI).
Data Sources: A structured search strategy was applied to the following biomedical databases from inception to
May 2013: PubMed, CINAHL, EMBASE (Ovid), PsycINFO, Scopus, Academic Search Premier, The Cochrane
Library, The Centre for Reviews and Dissemination and
Study Selection: Two researchers independently assessed publications against the following inclusion criteria:
English, human, multichannel implant, any validated tinnitus outcome described and level 1-2 evidence.
Data Extraction and Synthesis: Data was systematically extracted using a standardized, pretested data form
which was crosschecked. The form assessed patient population, study design, outcomes and generalizability.
Data was pooled to compare study populations.
Conclusions: This is the first systematic review in the world literature on the subject - 17 studies with 1267 adult
patients met the inclusion criteria. There is a 71% prevalence of tinnitus in cochlear implant candidates with
moderate levels of clinically significant handicap/distress. After CI, 40% of patients have complete elimination of
tinnitus, 91% have complete or partial suppression (and reduction of handicap/distress). Tinnitus remains
unchanged for 16%, worse in 9%, and induced in 8% of CI patients. Second side CI still has positive benefits on
tinnitus outcomes but slightly increased risk of tinnitus exacerbation in 16% and induction in 20% of patients.
This systematic review provides the evidence base for a new indication of cochlear implantation as an effective,
durable treatment for patients with single-sided deafness and severe/intractable tinnitus.