{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:16:18Z","timestamp":1790248578966,"version":"4.1.0"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018694","name":"HORIZON EUROPE Marie Sklodowska-Curie Actions","doi-asserted-by":"publisher","award":["764604"],"award-info":[{"award-number":["764604"]}],"id":[{"id":"10.13039\/100018694","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018694","name":"HORIZON EUROPE Marie Sklodowska-Curie Actions","doi-asserted-by":"publisher","award":["764604"],"award-info":[{"award-number":["764604"]}],"id":[{"id":"10.13039\/100018694","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020624","name":"NIHR Nottingham Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020624","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020624","name":"NIHR Nottingham Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020624","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Tinnitus is a common problem in patients with a cochlear implant (CI). Between 4% and 25% of CI recipients experience a moderate to severe tinnitus handicap. However, apart from handicap scores, little is known about the real-life impact tinnitus has on those with CIs. We aimed to explore the impact of tinnitus on adult CI recipients, situations impacting tinnitus, tinnitus-related difficulties and their management strategies, using an exploratory sequential mixed-method approach.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A 2-week web-based forum was conducted using Cochlear Ltd.\u2019s online platform, Cochlear Conversation. A thematic analysis was conducted on the data from the forum discussion to develop key themes and sub-themes. To quantify themes and sub-themes identified, a survey was developed in English with face validity using cognitive interviews, then translated into French, German and Dutch and disseminated on the Cochlear Conversation platform, in six countries (Australia, France, Germany, New Zealand, the Netherlands and United Kingdom). Participants were adult CI recipients experiencing tinnitus who received a Cochlear Ltd. CI after 18 years of age.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Four key themes were identified using thematic analysis of the discussion forum: tinnitus experience, situations impacting tinnitus, difficulties associated with tinnitus and tinnitus management. Among the 414 participants of the survey, tinnitus burden on average was a moderate problem without their sound processor and not a problem with the sound processor on. Fatigue, stress, concentration, group conversation and hearing difficulties were the most frequently reported difficulties and was reported to intensify when not wearing the sound processor. For most CI recipients, tinnitus seemed to increase when performing a hearing test, during a CI programming session, or when tired, stressed, or sick. To manage their tinnitus, participants reported turning on their sound processor and avoiding noisy environments.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The qualitative analysis showed that tinnitus can affect everyday life of CI recipients in various ways and highlighted the heterogeneity in their tinnitus experiences. The survey findings extended this to show that tinnitus impact, related difficulties, and management strategies often depend on sound processor use. This exploratory sequential mixed-method study provided a better understanding of the potential benefits of sound processor use, and thus of intracochlear electrical stimulation, on the impact of tinnitus.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0284719","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T18:14:31Z","timestamp":1682014471000},"page":"e0284719","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["The impact of tinnitus on adult cochlear implant recipients: A mixed-method approach"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2667-9499","authenticated-orcid":true,"given":"Kelly K. S.","family":"Assouly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Shabbir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas","family":"van Dijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek J.","family":"Hoare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Akeroyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Stokroos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Stegeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana L.","family":"Smit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"pone.0284719.ref001","first-page":"1","volume-title":"Progress in Brain Research","author":"D. De Ridder","year":"2021"},{"key":"pone.0284719.ref002","author":"I. Stegeman","year":"2021"},{"key":"pone.0284719.ref003","article-title":"A systematic review of the reporting of tinnitus prevalence and severity","author":"A. McCormack","year":"2016","journal-title":"Hearing Research"},{"key":"pone.0284719.ref004","doi-asserted-by":"crossref","first-page":"100250","DOI":"10.1016\/j.lanepe.2021.100250","article-title":"Tinnitus prevalence in Europe: a multi-country cross-sectional population study","volume":"12","author":"R. Biswas","year":"2022","journal-title":"Lancet Reg. Heal.\u2014Eur."},{"key":"pone.0284719.ref005","article-title":"Global Prevalence and Incidence of Tinnitus: A Systematic Review and Meta-analysis.","author":"C. M. Jarach","year":"2022","journal-title":"JAMA Neurol."},{"issue":"5","key":"pone.0284719.ref006","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1080\/14992020400050033","article-title":"Tinnitus and cochlear implantation","volume":"43","author":"N. Quaranta","year":"2004","journal-title":"International Journal of Audiology"},{"issue":"11","key":"pone.0284719.ref007","doi-asserted-by":"crossref","first-page":"2584","DOI":"10.1002\/lary.25370","article-title":"The effect of cochlear implantation on tinnitus in patients with bilateral hearing loss: A systematic review","volume":"125","author":"G. G. J. Ramakers","year":"2015","journal-title":"Laryngoscope"},{"key":"pone.0284719.ref008","article-title":"The Influence of Cochlear Implantation on Tinnitus in Patients with Single-Sided Deafness: A Systematic Review","author":"N. Peter","year":"2019","journal-title":"Otolaryngol.\u2014Head Neck Surg."},{"key":"pone.0284719.ref009","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/bs.pbr.2020.06.013","article-title":"Cochlear implantation for patients with tinnitus\u2014A systematic review.","volume":"260","author":"K. K. S. Assouly","year":"2021","journal-title":"Prog. Brain Res."},{"key":"pone.0284719.ref010","first-page":"23312165221128430","article-title":"Analysis of a Cochlear Implant Database: Changes in Tinnitus Prevalence and Distress After Cochlear Implantation.","volume":"26","author":"K. K. S. Assouly","year":"2022","journal-title":"Trends Hear."},{"key":"pone.0284719.ref011","article-title":"Insomnia, Anxiety and Depression in Adult Cochlear Implant Users With Tinnitus","author":"R. H. 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Audiol."},{"issue":"1","key":"pone.0284719.ref015","doi-asserted-by":"crossref","first-page":"14423","DOI":"10.1038\/s41598-022-18823-3","article-title":"Influence of tinnitus annoyance on hearing-related quality of life in cochlear implant recipients.","volume":"12","author":"K. K. S. Assouly","year":"2022","journal-title":"Sci. Rep."},{"issue":"1","key":"pone.0284719.ref016","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/AUD.0000000000000601","article-title":"A Cross-Sectional Questionnaire Study of Tinnitus Awareness and Impact in a Population of Adult Cochlear Implant Users","volume":"40","author":"P. A. Gomersall","year":"2019","journal-title":"Ear Hear."},{"issue":"11","key":"pone.0284719.ref017","article-title":"Systematic Review on Intra- and Extracochlear Electrical Stimulation for Tinnitus.","volume":"11","author":"K. K. S. 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Gagnier","year":"2021","journal-title":"Qual Life Res"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0284719","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T18:15:49Z","timestamp":1682014549000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0284719"}},"subtitle":[],"editor":[{"given":"Prashanth","family":"Prabhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":51,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4,20]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0284719","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,20]]}}}