Efficacy of intratympanic injection of dexamethasone in the treatment of subjective idiopathic tinnitus

Authors

  • Sandeep Shetty Department of ENT, JSS Medical College, Mysore, Karnataka, India
  • Ammu George Department of ENT, JSS Medical College, Mysore, Karnataka, India
  • Shilpa Chandrashekar Department of ENT, JSS Medical College, Mysore, Karnataka, India
  • Bhadravathi Ganesh Prakash Department of ENT, JSS Medical College, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20192729

Keywords:

Intratympanic injection, Dexamethasone, Subjective idiopathic tinnitus, Tinnitus handicap inventory, Tinnitus

Abstract

Background: To study the efficacy of intratympanic injection of dexamethasone in cases of subjective idiopathic tinnitus.

Methods: Prospective interventional study at the Department of ENT, JSS Medical College and Hospital, Mysore, in which 45 patients diagnosed clinically as subjective idiopathic tinnitus, for a duration of 2 years from October 2016 were included in the study. The patients were subjected to 3 intratympanic injections of dexamethasone once in a week for 3 weeks.  They received a 0.5 ml intratympanic injection of 4mg/ml dexamethasone solution. After topical anaesthesia, using a 2 ml syringe and a spinal needle no. 22, the assigned solution was administered under direct vision using an endoscope in the postero- inferior quadrant of the tympanic membrane. They were followed up at the end of 1 and 3 months from the last injection. Tinnitus handicap inventory was repeated during the follow up and was compared to the value at presentation.  

Results: There was a statistically significant improvement in the THI at the first follow up compared with the baseline THI. Whereas there was no statistically significant change in improvement rate from the 1st follow up to the 2nd follow up (p=0.7), however there is decrease in the improvement, which means the improvement is temporary, and starts reverting by the second visit to some extent.

Conclusions: It was observed that the improvement in the tinnitus was for a short term after intratympanic injection of dexamethasone.

Metrics

Metrics Loading ...

Author Biography

Ammu George, Department of ENT, JSS Medical College, Mysore, Karnataka, India

Department of ENT

3rd year post graduate

References

Weshahy HF, Mohamed ES, Salem MA, Hussein MM. Intra tratympanic injection of dexamethasone for controlling subjective idiopathic tinnitus. Egypt J Otolaryngol. 2015;31:224-30.

Shim HY. Intratympanic steroid injection in tinnitus management. Hanyang Medical Reviews. 2016;36:125-30.

Mahmoud EA, Hafize ME. Transtympanic dexamethazone treatment for control of subjective idiopathic tinnitus. El-minia Med Bull. 2004;15:240–52.

An YH, Yu KK, Kwak MY, Yoon SW, Shim HJ. Prognostic factors for the outcomes of intratympanic dexamethasone in the treatment of acute subjective tinnitus. Otol Neurotol. 2014;35:1330–7.

She W, Dai Y, Du X, Chen F, Zhang Q, Jiang P, Cui X. A short term study on the efficacies of intratympanic prednisolone and dexamethasone injection for subjective tinnitus. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008;22:871–3, 877.

Parnes LS, Sun AH, Freeman DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope. 1999;109:1–17.

Hamid MA. Intratympanic dexamethasone perfusion in Meniere’s disease. Presented at the spring meeting of the American Neurotology Society, Palm Desert, CA. 2001:12.

Araújo MFS, Oliveira CA, Bahmad Jr FM. Intratympanic dexamethasone injections as a treatment for severe, disabling tinnitus. Arch Otolaryngol Head Neck Surg. 2005;131:113–7.

House JW. Therapies for tinnitus. Am J Otol. 1989;10:163–5.

Parelkar K, Thorawade V, Jagade M, Nagle S, Nataraj R, Pandare M, et al. Intratympanic injections: an unsolved mystery. Int J Otolaryngol Head Neck Surg. 2015;4:124–32.

Pondugula SR, Sanneman JD, Wangemann P, Milhaud PG, Marcus DC. Glucocorticoids stimulate cation absorption by semicircular canal duct epithelium via epithelial sodium channel. American Journal Physiol Renal Physiol. 2004;286:1127–35.

Chandrasekhar SS, Rubinstein RY, Kwartler JA, Gatz M, Connelly PE, Huang E, et al. Dexamethasone pharmacokinetics in the inner ear: comparison of route of administration and use of facilitating agents. Otolaryngol Head and Neck Surg. 2000;122:521-8.

Topak M, Sahin-Yilmaz A, Ozdoganoglu T, Yilmaz, HB, Ozbay M, Kulekci M. Intratympanic methylprednisolone injections for subjective tinnitus. J Laryngol Otol. 2009;123:1221-5.

Belhassen S, Saliba I. Pain assessment of the intratympanic injections: a prospective comparative study. Eur Arch Otorhinolaryngol. 2012;269:2467–73.

Downloads

Published

2019-06-27

How to Cite

Shetty, S., George, A., Chandrashekar, S., & Prakash, B. G. (2019). Efficacy of intratympanic injection of dexamethasone in the treatment of subjective idiopathic tinnitus. International Journal of Otorhinolaryngology and Head and Neck Surgery, 5(4), 1056–1060. https://doi.org/10.18203/issn.2454-5929.ijohns20192729

Issue

Section

Original Research Articles