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Successful hearing improvement with direct acoustic stimulation in a patient with schizophrenia

  • J Rebol (a1) (a2), M Kravos (a3) and M Ložar (a1)

Abstract

Objective

A direct acoustic cochlear implant provides its power directly to the inner ear by vibrating the perilymph via a conventional stapes prosthesis. Our experience with a patient with severe mixed hearing loss due to otosclerosis is described.

Case report

The patient, a 47-year-old male, had a pre-operative speech recognition score of 10 per cent and had been treated for many years for schizophrenia, both of which made him a poor candidate for a direct acoustic stimulation device. Nevertheless, the surgery was performed, which preserved the pre-operative bone conduction level and significantly improved hearing. His speech recognition score rose to 100 per cent. He uses the device all day and his auditory hallucinations have subsided. Improvement of schizophrenia symptoms has enabled the patient to reduce his psychiatric medications intake.

Conclusion

Hearing restoration was the main reason for the reduction of auditory hallucinations in our patient. Hearing loss is a potentially reversible risk factor for psychosis, but this association is often overlooked.

Copyright

Corresponding author

Author for correspondence: Dr Janez Rebol, Department of Otorhinolaryngology and Maxillofacial Surgery, Maribor University Clinical Center, Ljubljanska 5, 2000 Maribor, Slovenia E-mail: janez.rebol@guest.arnes.si

Footnotes

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Dr J Rebol takes responsibility for the integrity of the content of the paper

Footnotes

References

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1Häusler, R, Stieger, C, Bernhard, H, Kompis, M. A novel implantable hearing system with direct acoustic cochlear stimulation. Audiol Neurootol 2008;13:247–56
2Lenarz, T, Zwartenkot, JW, Stieger, C, Schwab, B, Mylanus, EA, Caversaccio, M et al. Multicenter study with a direct acoustic cochlear implant. Otol Neurotol 2013;34:1215–25
3Lenarz, T, Schwab, B, Maier, H, Kludt, E. Direct acoustic cochlear stimulation for therapy of severe to profound mixed hearing loss: Codacs™ Direct Acoustic Cochlear Implant System [in German]. HNO 2014;62:481–9
4Lenarz, T, Verhaert, N, Desloovere, C, Desmet, J, D'hondt, C, González, JC et al. A comparative study on speech in noise understanding with a direct acoustic cochlear implant in subjects with severe to profound mixed hearing loss. Audiol Neurootol 2014;19:164–74
5Busch, S, Kruck, S, Spickers, D, Leuwer, R, Hoth, S, Praetorius, M et al. First clinical experiences with a direct acoustic cochlear stimulator in comparison to preoperative fitted conventional hearing aids. Otol Neurotol 2013;34:1711–18
6Schwab, B, Kludt, E, Maier, H, Lenarz, T, Teschner, M. Subtotal petrosectomy and Codacs™: new possibilities in ears with chronic infection. Eur Arch Otorhinolaryngol 2016;273:1387–91
7Schizophrenia Spectrum and Other Psychotic Disorders. In: http://dsm.psychiatryonline.org/doi/ref/10.1176/appi.books.9780890425596.dsm02 [14 November 2017]
8Linszen, MM, Brouwer, RM, Heringa, SM, Sommer, IE. Increased risk of psychosis in patients with hearing impairment: review and meta-analyses. Neurosci Biobehav Rev 2016;62:120
9Sommer, IE, Roze, CM, Linszen, MM, Somers, M, van Zanten, GA. Hearing loss; the neglected risk factor for psychosis. Schizophr Res 2014;158:266–7
10Gevonden, M, Booij, J, van den Brink, W, Heijtel, D, van Os, J, Selten, JP. Increased release of dopamine in the striata of young adults with hearing impairment and its relevance for the social defeat hypothesis of schizophrenia. JAMA Psychiatry 2014;71:1364–72
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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