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Abstract: Tinnitus and hyperacusis are new challenged emergent indications of cochlear implantation. Some reports have demonstrated a suppression of tinnitus as a side effect after implantation. We describe the case of a 57-year-old man suffering from severe tinnitus and hyperacusis. Several years after onset of symptoms cochlear implantation was performed, which resulted in a progressive decrease of tinnitus and hyperacusis.
Submitted : 30 November 2010 Revised: 05 April 2011 Accepted : 07 April 2011
Introduction
Indications of cochlear implantation are wide spreading through the field of auditory disorders and not only are recommended in severe to profound hearing loss. Some of these emergent indications of cochlear implantation are tinnitus and hyperacusis. Tinnitus consists of perception of sounds in the absence of an acoustic stimulus and it must be distinguished from the somato-sounds, which are sounds that are originated near the cochlea in vascular and musculoskeletal structures. Tinnitus is a prevalent symptom that affects from 15% to 30% of adult population [1].
In many occasions tinnitus is associated to hyperacusis which has been defined as consistently exaggerated or inappropriate responses to sounds that are neither threatening nor uncomfortably loud to typical person [2]. Hyperacusis may be distinguished from loudness recruitment that describes an experience commonly associated to cochlear hearing loss which consists of a perception of loudness level increases faster than normal with a rising sound level [3]. The prevalence of hyperacusis in patients with tinnitus as the primary complaint is about 40% [4] and the prevalence of tinnitus in the patients with a primary complaint of hyperacusis has been reported as 86% [5].
Tinnitus and hyperacusis could be very incapacitating in certain people. It is estimated that one to five per cent of the people who suffer from tinnitus are severely affected. Tinnitus may affect mental functioning and cause psychological distress, including anxiety and depression. There is great evidence that the annoyance of the tinnitus is not the perception of the tinnitus itself but the way in which patients experience the perception [6]. The same seems to be true in the case of hyperacusis. That is the reason why it is necessary to assess the grade of annoyance of both symptoms not only by an audiological assessment but by general and specific test...