{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T06:28:02Z","timestamp":1772000882100,"version":"3.50.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This prospective study aims to identify factors that may influence the long-term aggravation of tinnitus following cochlear implant (CI) surgery. The variables examined include age, gender, pre- and post-operative residual hearing, duration of deafness, etiology of hearing impairment, cochlear anatomy, as well as the insertion depth and angle of the CI electrode array.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 65 patients were assessed pre-operatively and at 2 days, 4 weeks, 12 months, and 24 months after CI surgery. Age, gender, duration of deafness, and etiology were recorded through anamnesis. Residual hearing before and after implantation was evaluated using the air conduction (AC) thresholds in four frequencies (500, 1,000, 2,000, and 4,000 Hz) in pure-tone audiometry (PTA-4). Cochlear dimensions (distances and height), insertion depth, and insertion angle were measured using post-operative digital volume tomography. Tinnitus burden and intensity were assessed with the Visual Analog Scale (VAS) and the Tinnitus Questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, tinnitus burden significantly decreased during the course of CI treatment. However, 38% of patients reported increased tinnitus intensity on the second post-operative day, with this proportion remaining relatively stable (36%) after 2 years. Meanwhile, 33% of patients experienced an increase of tinnitus burden shortly after implantation, decreasing to 21% 1 year post-operatively. None of the examined factors\u2014including age, gender, residual hearing, duration of deafness, etiology, cochlear anatomy, insertion depth, or insertion angle\u2014were associated with an increased risk of pre-operative tinnitus burden or post-operative tinnitus exacerbation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Distributive and morphological factors did not significantly influence tinnitus exacerbation before or after CI. Nevertheless, tinnitus symptoms improved significantly over time. Future studies should investigate additional potential contributing factors, such as psychological comorbidities, in the development or persistence of tinnitus following CI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1781522","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T05:34:08Z","timestamp":1771997648000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigation of distributive, morphological and audiological factors influencing the long-term aggravation of tinnitus following cochlear implant provision"],"prefix":"10.3389","volume":"17","author":[{"given":"Friederike","family":"Everad","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg","place":["Freiburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antje","family":"Aschendorff","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg","place":["Freiburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann-Kathrin","family":"Rauch","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg","place":["Freiburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonie","family":"Fries","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg","place":["Freiburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Arndt","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg","place":["Freiburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel Christoph","family":"Ketterer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg","place":["Freiburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s00106-019-00739-6","article-title":"Influence of single-sided deafness on the auditory capacity of the better ear","volume":"68","author":"Arndt","year":"2020","journal-title":"HNO"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1089610","DOI":"10.3389\/fneur.2022.1089610","article-title":"Effects of auditory rehabilitation with cochlear implant on tinnitus prevalence and distress, health-related quality of life, subjective hearing and psychological comorbidities: comparative analysis of patients with asymmetric hearing loss (AHL), double-sided (bilateral) deafness (DSD), and single-sided (unilateral) deafness (SSD)","volume":"13","author":"Olze","year":"2023","journal-title":"Front Neurol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2289","DOI":"10.1007\/s00405-020-06315-x","article-title":"Single-centre experience and practical considerations of the benefit of a second cochlear implant in bilaterally deaf adults","volume":"278","author":"P\u00e9us","year":"2021","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1599369","DOI":"10.3389\/fneur.2025.1599369","article-title":"The influence of CI electrode array design on the preservation of residual hearing","volume":"16","author":"Fries","year":"2025","journal-title":"Front Neurol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"4095","DOI":"10.1007\/s00405-024-08568-2","article-title":"Implantation and reimplantation: epidemiology, etiology and pathogenesis over the last 30 years","volume":"281","author":"Ketterer","year":"2024","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1477259","DOI":"10.3389\/fneur.2024.1477259","article-title":"Are tinnitus burden and tinnitus exacerbation after cochlear implantation influenced by insertion technique, array dislocation, and intracochlear trauma?","volume":"15","author":"Everad","year":"2024","journal-title":"Front Neurol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1159\/000323847","article-title":"The impact of cochlear implantation on tinnitus, stress and quality of life in postlingually deafened patients","volume":"17","author":"Olze","year":"2012","journal-title":"Audiol Neurootol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e441","DOI":"10.1097\/MAO.0000000000002179","article-title":"Age dependent psychological factors influencing the outcome of Cochlear implantation in elderly patients","volume":"40","author":"Knopke","year":"2019","journal-title":"Otol Neurotol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e430","DOI":"10.1097\/MAO.0000000000002008","article-title":"Long-term benefit of unilateral cochlear implantation on quality of life and speech perception in bilaterally deafened patients","volume":"40","author":"H\u00e4u\u00dfler","year":"2019","journal-title":"Eur Acad Otol Neurotol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s00405-017-4842-y","article-title":"The influence of cochlear morphology on the final electrode array position","volume":"275","author":"Ketterer","year":"2018","journal-title":"Eur Arch Otorhinolaringol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2683","DOI":"10.1007\/s00405-018-5135-9","article-title":"Asymmetric hearing loss and the benefit of cochlear implantation regarding speech perception, tinnitus burden and psychological comorbidities: a prospective follow-up study","volume":"275","author":"Ketterer","year":"2018","journal-title":"Eur Arch Otorhinolaringol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e563","DOI":"10.1097\/MAO.0000000000002590","article-title":"Binaural hearing rehabilitation improves speech perception, quality of life, tinnitus distress, and psychological comorbidities","volume":"41","author":"Ketterer","year":"2020","journal-title":"Otol Neurotol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/S0079-6123(07)66033-6","article-title":"Cochlear implants and tinnitus","volume":"166","author":"Baguley","year":"2007","journal-title":"Prog Brain Res"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1097\/MAO.0000000000000431","article-title":"Cochlear implantation in unilateral sudden deafness improves tinnitus and speech comprehension: meta-analysis and systematic review","volume":"35","author":"Blasco","year":"2014","journal-title":"Am J Otol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1080\/14992020400050033","article-title":"Tinnitus and cochlear implantation","volume":"43","author":"Quaranta","year":"2004","journal-title":"Int J Audiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1016\/S0140-6736(13)60142-7","article-title":"Tinnitus","volume":"382","author":"Baguley","year":"2013","journal-title":"Lancet"},{"key":"B17","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.heares.2017.01.003","article-title":"Cochlear synaptopathy in acquired sensorineural hearing loss: manifestations and mechanisms","volume":"349","author":"Liberman","year":"2017","journal-title":"Hear Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"65","DOI":"10.3389\/fsurg.2017.00065","article-title":"Tinnitus after simultaneous and sequential bilateral cochlear implantation","volume":"4","author":"Ramakers","year":"2017","journal-title":"Front Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1002\/lio2.224","article-title":"Models to predict positive and negative effects of cochlear implantation on tinnitus","volume":"4","author":"Kloostra","year":"2019","journal-title":"Laryngoscope Invest Otolaryngol"},{"key":"B20","author":"G\u00f6bel","year":"1998","journal-title":"Tinnitus-Fragebogen:(TF); ein Instrument zur Erfassung von Belastung und Schweregrad bei Tinnitus; Handanweisung"},{"key":"B21","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1159\/000095611","article-title":"The size of the cochlea and predictions of insertion depth angles for cochlea implant electrodes","volume":"11","author":"Escud\u00e9","year":"2006","journal-title":"Audiol Neurootol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"3707","DOI":"10.1007\/s00405-020-06434-5","article-title":"Radiological evaluation of a new straight electrode array compared to its precursors","volume":"278","author":"Ketterer","year":"2021","journal-title":"Eur Arch Otorhinolaringol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1007\/s00405-024-09147-1","article-title":"The influence of electrode array design, scalar dislocation and insertion technique on postoperative vertigo in CI surgery - a prospective study","volume":"282","author":"Ketterer","year":"2025","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"4853","DOI":"10.1007\/s00405-022-07315-9","article-title":"Scalar position, dislocation analysis and outcome in CI reimplantation due to device failure","volume":"279","author":"Beck","year":"2022","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"S50","DOI":"10.1055\/a-1950-6149","article-title":"Tinnitus and Influencing Comorbidities","volume":"102","author":"Mazurek","year":"2023","journal-title":"Laryngorhinootologie"},{"key":"B26","doi-asserted-by":"publisher","first-page":"706","DOI":"10.3389\/fnins.2020.00706","article-title":"Gender-specific risk factors and comorbidities of bothersome tinnitus","volume":"14","author":"Basso","year":"2020","journal-title":"Front Neurosci"},{"key":"B27","doi-asserted-by":"publisher","first-page":"487","DOI":"10.3389\/fnins.2020.00487","article-title":"Gender-specific differences in patients with chronic tinnitus \u2013 baseline characteristics and treatment effects","volume":"14","author":"Niemann","year":"2020","journal-title":"Front Neurosci"},{"key":"B28","doi-asserted-by":"publisher","first-page":"646","DOI":"10.3390\/jcm13030646","article-title":"Investigation of maximum monosyllabic word recognition as a predictor of speech understanding with cochlear implant","volume":"13","author":"Czurda","year":"2024","journal-title":"J Clin Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1002\/lio2.528","article-title":"Duration of deafness impacts auditory performance after cochlear implantation: a meta-analysis","volume":"6","author":"Bernhard","year":"2021","journal-title":"Laryngoscope Investig Otolaryngol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2331216518813802","DOI":"10.1177\/2331216518813802","article-title":"Effect of tinnitus and duration of deafness on sound localization and speech recognition in noise in patients with single-sided deafness","volume":"22","author":"Liu","year":"2018","journal-title":"Trends Hear"},{"key":"B31","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1179\/1754762812Y.0000000017","article-title":"Influence of etiologic factors on speech perception of cochlear-implanted children","volume":"14","author":"Janeschik","year":"2013","journal-title":"Cochlear Implants Int"},{"key":"B32","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/s00701-016-2996-9","article-title":"Translabyrinthine vestibular neurectomy and simultaneous cochlear implant for M\u00e9ni\u00e8re's disease","volume":"159","author":"Canzi","year":"2017","journal-title":"Acta Neurochir"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.1097\/MAO.0000000000000202","article-title":"Cochlear implantation in patients with advanced M\u00e9ni\u00e8re's disease","volume":"35","author":"Mick","year":"2014","journal-title":"Otol Neurotol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"4257","DOI":"10.1007\/s00405-021-07160-2","article-title":"Electrode array design determines scalar position, dislocation rate and angle and postoperative speech perception","volume":"279","author":"Ketterer","year":"2022","journal-title":"Eur Arch Otorhinolaringol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1097\/AUD.0000000000000670","article-title":"Early sentence recognition in adult cochlear implant users","volume":"40","author":"James","year":"2019","journal-title":"Ear Hear"},{"key":"B36","doi-asserted-by":"publisher","first-page":"e045","DOI":"10.1097\/ONO.0000000000000045","article-title":"Effect of cochlear implant electrode insertion depth on speech perception outcomes: a systematic review","volume":"3","author":"Breitsprecher","year":"2023","journal-title":"Otol Neurotol Open"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1781522\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T05:34:09Z","timestamp":1771997649000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1781522\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":36,"alternative-id":["10.3389\/fneur.2026.1781522"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1781522","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"article-number":"1781522"}}