Cochlear Implantation for Treatment of Tinnitus in Single-sided Deafness: A Systematic Review and Meta-analysis

Objective: Quantify the benefit of cochlear implantation (CI) for tinnitus relief among individuals with single-sided deafness (SSD). Data Sources: PubMed, Scopus, and Cochrane databases were searched through July 10, 2019. Search strategies used a combination of subject headings (e.g., MeSH in PubMed) and keywords for the following three concepts: single-sided deafness, cochlear implantation, and tinnitus. Study Selection: English articles that reported the preintervention (baseline) tinnitus-related patient-reported outcome measures (e.g., Tinnitus Handicap Inventory [THI] and Visual Analog Scale [VAS] for loudness) in patients with SSD that underwent CI were included. Data Extraction: Number of patients, mean age, etiology of hearing loss, duration of deafness, baseline and follow-up THI and VAS scores. Data Synthesis: A total of 17 studies met inclusion criteria encompassing 247 patients with SSD receiving a cochlear implant (mean age 50.2 yr, range 23–71). For THI, CI resulted in a mean difference of –35.4 points [95% CI –55.8 to –15.0, p < 0.001]. VAS decreased by –4.6 points [CI –6.0 to –3.3, p < 0.001]. A weighted proportion of 14.9% [CI 6.4–26.1] of patients experienced complete resolution of tinnitus, while 74.5% [CI 63.1–84.5] experienced partial improvement; 7.6% [CI 4.1–12.6] of patients had no change in severity, and 3.0% [CI 1.0–6.7] experienced worsening of their tinnitus. Conclusions: On both THI and VAS, patients reported significant reduction in their scores, representing an overall improvement in tinnitus severity while wearing the cochlear implant. Most patients with SSD will experience partial improvement or complete resolution of tinnitus with a cochlear implant.