Comparing Tinnitus Suppression in Asymmetric Hearing Loss and Single-Sided Deafness: Cochlear Versus Bone Conduction Implants.

Objectives: Implantable hearing devices, such as cochlear implants (CI) and bone conduction implants (BCI), are options for hearing rehabilitation in patients with asymmetric hearing loss (AHL) and single-sided deafness (SSD). This study aimed to compare the effects of CI and BCI on tinnitus in AHL/SSD patients with tinnitus.

Methods: This retrospective study enrolled adult AHL/SSD patients with significant tinnitus who underwent CI or BCI placement between 2017 and 2023. Clinical characteristics, preoperative and postoperative audiologic test results, and tinnitus questionnaires (tinnitus handicap inventory, THI; visual analog scale, VAS) were collected and analyzed.

Results: Of 33 AHL/SSD patients with significant tinnitus (THI ≥ 18), 16 received CI and 17 BCI. In the CI group, all four VAS scores (loudness, awareness, annoyance, and effect on life) and THI scores significantly improved. In the BCI group, annoyance and effect on life categories of VAS and THI scores significantly improved, while VAS loudness and awareness remained similar. Linear mixed model analysis showed that the decrease in VAS loudness, awareness, and annoyance scores was significantly greater in the CI group compared to the BCI group. The CI group showed a significantly higher tinnitus cure rate (62.5.0%) compared with the BCI group (11.8%) at 6-months postoperative.

Conclusion: Both CI and BCI effectively improved tinnitus in AHL/SSD patients with tinnitus. However, CI is considered the first-line therapeutic option for tinnitus due to its stronger effect on tinnitus suppression as well as the higher cure rate in SSD/AHL patients with tinnitus.