Turkish Archives of Otorhinolaryngology (Jun 2006)
Effectiveness of intratympanic dexamethasone on tinnitus: a clinical experience
Abstract
Objectives: To report our experience about intratympanic dexamethasone (ITDex) injection in the management of patients with tinnitus.Methods: The records of all patients with tinnitus presenting for treatment at our institution between 2002 and 2004 were retrospectively reviewed. Forty patients’ data (11 women and 29 men; aged 54±11 years; range, 32 to 76 years) were collected. Inclusion criteria consisted of having a minimum 6 months’ medical therapy for tinnitus and being free of hypertension, diabetes mellitus, hypo-hyperthyroidism, hypercholesterolemia, Meniere’s disease, otosclerosis, and chronic otitis media diseases. Intratympanic injections of 4 mg/mL dexamethasone had been performed 5 times at 2-day intervals. Before and 5 days after the injections, audiometry, including high-frequency and tinnitus-matching tests, had been performed. The efficacy of therapy was evaluated with a visual analog scale (VAS) before and 5 days after treatment and in the late period. A 20 mm improvement on the visual analog scale was considered to be significant. Paired-samples t and Wilcoxon signedrank tests were used to determine statistical significance (P<0.05).Results: When visual analog scale values before and after treatment, and before treatment and late period were compared, patients’ annoyance from tinnitus was significantly decreased (both P<0.001). There were also significant decreases on tinnitus loudness (P=0.049) and pure tone averages (P=0.038). There was no significant difference regarding the speech discrimination scores of the patients (P=0.865). The improvement rates based on visual analog scale were 40% (16 of 40 patients) for before and after treatment and 37% (13 of 35 patients) for before treatment and late period. Follow-up varied from 12 to 33 months.Conclusion: Without affecting hearing status, ITDex treatment can improve not only patients’ annoyance from tinnitus and tinnitus loudness but also pure tone averages. This treatment appears to be a successful and safe alternative for the treatment of tinnitus.
