Evaluating How a Tinnitus Implant Affects Tinnitus Loudness in Adults With Chronic Tinnitus and Varying Levels of Hearing Loss (TINIS)

A Prospective, Multicentric, Feasibility Investigation to Assess the Effect of the Tinnitus Implant on Tinnitus Loudness in Adults With Moderate to Severe Chronic Tinnitus Accompanied by Normal Hearing to Moderately Severe Hearing Loss.

This study will test an experimental Tinnitus Implant System that consists of a cochlear implant, sound processor and programming software. The Tinnitus implant is surgically placed under the skin just behind the ear in the mastoid bone. It has an electrode that extends from the implant into the promontory bone of the cochlea which emits electrical signals that stimulate the auditory nerve. The sound processor is worn behind the ear and powers the implant via the coil. The study will be conducted in adults with moderate to severe chronic tinnitus who have normal hearing to moderately severe hearing loss in the inner ear. The study participants will undergo a series of tests that include evaluations of tinnitus loudness and annoyance, and self-reported questionnaires on their tinnitus and general health.

Study Overview

• Status: Recruiting
• Conditions: Normal Hearing; Tinnitus; Hearing Loss, Bilateral or Unilateral
• Intervention / Treatment: Device: Tinnitus Implant System

• Study Type: Interventional
• Enrollment (Estimated): 16
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Remo Arts; Phone Number: +31615326086; Email: rarts@cochlear.com
• Study Contact Backup: Name: Kelly Assouly; Email: kassouly@cochlear.com

Study Locations

• Belgium
  • Belgium
    • Edegem, Belgium, Belgium, B-2650
      • Recruiting
      • Antwerp University Hospital (UZA)
      • Contact: Prof. Dr. Marc Lammers; Phone Number: +32 3 821 33 85; Email: Marc.Lammers@uza.be
• Netherlands
  • Utrecht, Netherlands, 3508
    • Recruiting
    • University Medical Center Utrecht
    • Contact: Prof. Dr. Robert J. Stokroos; Phone Number: +31 88 75 566 44; Email: R.J.Stokroos@umcutrecht.nl

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion criteria

• 18 years or older.
• Normal hearing to moderately severe sensorineural hearing loss defined as a pure tone average (PTA) at 500, 1000, 2000 and 4000 Hz less than 65 dB HL in both ears (separately) and best-aided phoneme recognition score more than or equal to 80% in both ears (separately).
• Unilateral or asymmetric subjective (no pulsatile) tinnitus. In case of asymmetric tinnitus, the worst ear must be implanted.
• Tinnitus duration of at least 6 months.
• Severe tinnitus loudness determined by a. VAS-L score in the severe range i.e. 50-100/100 b. TFI score in the severe range i.e. 52-90/100
• Tinnitus that is intractable and has not been ameliorated satisfactorily by standard of care such as CBT or hearing aid, when such interventions are potentially clinically indicated.
• Clinically significant reduction in VAS-L score (≥ 15/100 points) in response to trans-tympanic promontory stimulation
• Willing and able to provide written informed consent.
• Medically able to use the device and to undergo general anaesthesia for implantation taking into account their medical condition, contraindications and surgical risks.
• Dutch language proficiency

Exclusion Criteria:

• Pulsatile tinnitus.
• Any anatomical or structural abnormalities of the inner ear, cochlear nerve, or brainstem that would negatively impact response to study intervention (determined in a temporal bone CT and if necessary (e.g. possibility of vestibular/acoustic schwannoma) by a MRI scan of the head (of sufficient quality at the discretion of the investigator) not more than five years old at the time of enrolment
• Medical contraindications limiting correct placement, activation, or treatment (determined by medical history; contraindications include brain or major ear surgery, brain or temporal bone tumor(s), recurrent ear infections within the last year, otosclerosis, prior major head trauma that results in sudden injury that causes damage to the brain and results in lasting cognitive impairment).
• Any medical condition, including mental illness or substance abuse, deemed by the Investigator to likely interfere with a patient's ability to sign informed consent, cooperate and/or participate in the study, or interfere with the interpretation of the results (incl. pregnant or breastfeeding women or patients with unrealistic expectations).
• Presence of clinically diagnosed depression or anxiety determined by a psychological state evaluation (if PHQ-9 > 9 or GAD-7 > 9).
• Active (currently or within two months prior to enrolment) use of medications (taking regularly scheduled antidepressant, anxiolytic, antipsychotic or antiepileptic medications, or other neuromodulator agents) or other tinnitus treatments.
• It is permissible to include people who use such medications at lower doses as a sleep aid or for people who intermittently use such medications for situational anxiety (e.g., Ativan before airplane travel). A change in medication during the trial should be avoided.
• It is permissible to include people who prefer to use a hearing aid to amplify ipsilateral hearing loss. The start of using a hearing aid during the trial should be avoided.
• Investigator site personnel directly affiliated with this study and/or their immediate families; immediate family is defined as a spouse, parent, child, or sibling.
• Cochlear employees or employees of Contract Research Organizations or contractors engaged by Cochlear for the purposes of this investigation.
• Current participation, or participation in another interventional clinical study/trial in the past 60 days, involving an investigational drug or device (unless the other investigation was/is a Cochlear sponsored investigation and determined by the investigator or Sponsor to not impact this investigation).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Tinnitus Implant System; Tinnitus Implant	Device: Tinnitus Implant System; Implanted with Tinnitus Implant System: Active Implantable Medical Device

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean change in tinnitus loudness from baseline to 6 months post-activation of the Tinnitus Implant System	Self-reported tinnitus loudness as measured on the Visual Analogue Scale-Loudness (VAS-L) where 0 is equivalent to absence of tinnitus and 100 indicates tinnitus of the greatest loudness severity	Pre-operative baseline to 6 months post Tinnitus Implant System activation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reported device or procedure related adverse events and harms	Number of device and procedure-related adverse events and reported harms	Pre-operative baseline to 6 months post Tinnitus Implant System activation
Mean change in tinnitus annoyance from baseline to 6 months post activation of the Tinnitus Implant System	Self-reported tinnitus loudness as measured on the Visual Analogue Scale-Annoyance (VAS-A) where 0 is equivalent to absence of tinnitus and 100 indicates tinnitus of the greatest annoyance severity	Pre-operative baseline to 6 months post Tinnitus Implant System activation
Mean change in tinnitus perception from baseline to 6 months post activation of the Tinnitus Implant System	Self-reporting on the Tinnitus Functional Index (TFI) questionnaire	Pre-operative baseline to 6 months post Tinnitus Implant System activation
Change in self-reported matches of tinnitus pitch and loudness to acoustic stimuli	Patient reported matching of tinnitus pitch (Hz) and loudness (dB SPL) with acoustic stimuli	Pre-operative baseline, activation (Implant activation is approximately 10 weeks after surgical implantation of Tinnitus implant), 3 months post activation, 6 months post activation
Mean change in health-related quality of life with Tinnitus Implant System	Score of Glasgow Benefit Inventory (GBI) questionnaire	6 months post Tinnitus Implant System activation
Mean change in health status with Tinnitus Implant System	Score of Patient Global Impression of Change (PGIC) questionnaire	At 6 months post Tinnitus Implant System activation
Mean change in speech perception in quiet from baseline to 6 months post-activation	Word recognition in quiet presented at 65 dB SPL in the unaided condition	Pre-operative baseline to 6 months post Tinnitus Implant System activation
Mean change in hearing thresholds from baseline to 6 months post-activation	Bone conduction thresholds (dB HL) at any tested frequency (0.25, 0.5, 1, 1.5, 2, 4 kHz) from baseline to 6 months post-activation in the implanted ear	Pre-operative baseline to 6 months post Tinnitus Implant System activation

Collaborators and Investigators

• Sponsor: Cochlear
• Investigators: Study Director: Remo Arts, Cochlear

Study record dates

Study Major Dates

• Study Start (Actual): June 16, 2025
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): July 1, 2027

Study Registration Dates

• First Submitted: October 8, 2024
• First Submitted That Met QC Criteria: October 13, 2024
• First Posted (Actual): October 15, 2024

Study Record Updates

• Last Update Posted (Actual): June 2, 2026
• Last Update Submitted That Met QC Criteria: June 1, 2026
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: cochlear implant; tinnitus
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Otorhinolaryngologic Diseases; Sensation Disorders; Ear Diseases; Hearing Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Hearing Loss; Tinnitus
• Other Study ID Numbers: AI5856

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No