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Tinnitus Distress, Anxiety, Depression, and Hearing Problems among Cochlear Implant Patients with Tinnitus

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While several studies have investigated the presence and annoyance of tinnitus in cochlear implant (CI) recipients, few studies have probed the handicap experienced in association with tinnitus in this population.


The aim of this study was to use validated self-report measures in a consecutive sample of CI patients who reported tinnitus in order to determine the extent of tinnitus handicap.

Research Design:

In a retrospective design, a total of 151 patients (80% response rate) responded to a postal questionnaire, and of these, 111 (74%) reported that they currently experienced tinnitus and were asked to complete the full questionnaire. Sampling was performed at a point of a mean 2.9 years postsurgery (SD  =  1.8 years). Three established self-report questionnaires were included measuring tinnitus handicap (Tinnitus Handicap Inventory [THI]), hearing problems (Gothenburg Profile), and finally, a measure of anxiety and depression (Hospital Anxiety and Depression Scale). We analyzed the data by means of Pearson product moment correlations, t-tests, ANOVAs, and chi-square.


Data from the validated questionnaires showed relatively low levels of tinnitus distress, moderate levels of hearing problems, and low scores on the anxiety and depression scales. Using the criteria proposed for the THI (which was completed by 107 patients), 35% (N  =  38) had a score indicating “no handicap,” 30% (N  =  32) “mild handicap” 18% (N  =  19) “moderate handicap”, and 17% (N  =  18) “severe handicap.” Thus 37 individuals from the total series of 151 reported moderate to severe tinnitus handicap (24.5%). Tinnitus distress was associated with increased hearing problems, anxiety, and depression.


Tinnitus can be a significant problem following CI, but that the experienced distress is often moderate. However, a quarter of CI recipients do demonstrate moderate/severe tinnitus handicap, and thus are candidates for tinnitus specific therapy. The level of tinnitus handicap is associated with hearing problems and psychological distress.
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Keywords: Anxiety; cochlear implant; depression; hearing problems; tinnitus distress

Document Type: Research Article

Publication date: May 1, 2009

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