DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20195694

Comparative study of the efficacy of oral caroverine versus oral Gingko biloba in the treatment of cochlear synaptic tinnitus

Sachin Jain, Kinshuk Chatterjee, M. Aftab, Dinesh Kumar, Ramsiya Singh, Ved P. Upadhyay

Abstract


Background: Cochlear synaptic tinnitus (CST), also referred to as sensorineural type III tinnitus, is a type of transformation tinnitus, resulting due to aberrant signal transduction between Inner hair cells and afferent nerve fibres owing to excessive and pathologic glutamate release and subsequent spontaneous receptor depolarization (NMDA and AMPA receptors). Of the various pharmacologic agents used for treatment for CST, Gingko biloba and Caroverine have stood the test of time.

Methods: A total 48 selected patients of CST, otherwise free from any medical or surgical co-morbidity, were included in the study and divided randomly in two groups, one group receiving oral formulation of Caroverine and the other group receiving oral Gingko biloba in appropriate doses. Both the groups were followed up for 12 weeks. Treatment outcomes were measured in terms of improvement in subjective symptoms (tinnitus grading) and psycho-acoustic measure (tinnitus matching).

Results: Although oral caroverine yielded promising results in the initial month of treatment in terms of improved tinnitus matching, long term effect was found to be dissatisfying. Oral Gingko biloba, at the completion of 12 weeks of therapy was found to be more effective in terms of improvement of mean tinnitus grading and matching (p<0.05). Side effects of the test drugs were not noted in either group.

Conclusions: Gingko biloba is thus found to be more effective treatment modality for CST for long term basis and is also readily available in the market, cost effective and free of side effects as well.


Keywords


Cochlear synaptic tinnitus, Caroverine, Gingko biloba

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References


Hazell JWP. Models of Tinnitus: Generation, perception, clinical implication, In: Vernon JA, Moller AR (eds). Mechanism of Tinnitus. Needhams Heights, MA: Allyn and Bacon; 1995;8:221-54.

Jasterboff PJ, Phantom auditory perception (tinnitus): Mechanism of generation and perception. Neurosci Res. 1990;8:221-54.

Fowler EP. Subjective head noises (tinnitus aurium): Genesis and differential, diagnostic significance. A few facts and several speculations. Laryngoscope. 1965;75:1610-8.

National Centre for Health Statistics. Hearing status and ear examinations: Findings among adults. United States, 1960-1962. Vital and health statistics series, 11, no. 32, US Department of HEW, Washington DC; 1968.

Cooper JC. Tinnitus, subjective hearing loss and well-being. Health and Nutrition Examination Survey of 1971-75: part II. J Am Acad Audiol. 1994;5:37-43.

Smith P, Coles R. Epidemiology of Tinnitus: An update. In: Feldman H (ed.). Proceeding of the III International Tinnitus Seminar, Munster. Karlsruhe: Harsch Verlag; 1987: 147-153.

Tyler RS, Kelsay D. Advantages and disadvantages reported by some of the better cochlear-implant patients. Am J Otol. 1990;11:282-9.

Coles RRA. Epidemiology of tinnitus: Prevalence and Demographic and clinical features. J Laryngol Otol Suppl. 1984;9:7-15,195-202.

Ehrenberger K, Felix D. Receptor pharmacological models for inner ear therapies with emphasis on glutamate receptors. Acta Otolaryngol. 1995;115:236-40.

Denk DM, Heinzl H, Franz P, Ehrenberger K. Caroverine in tinnitus treatment. A placebo-controlled blind study. Acta Otolaryngol. 1997;117:825-30.

D’Souza D, D’Souza S, Kochure J, Khandhar V, Ahuja V. A study to evaluate the efficacy and safety of a single infusion of Caroverine in cases of Cochlear Synaptic Tinnitus. 30th Annual Meeting of the society of Neurootological and Equilibriometical Society (NES) Porto-Portugal; 2003.

Meyer B. Etude multicentre randomise a double insuface au placebo du traitement des acouphenes par l’ extrait de Ginkgo biloba. La PresseMedicale. 1986;15:1562-4.

Morgenstern C, Biermann E. Ginkgo-spezial extra ktEgb 761 in der Behand lung des Tinnitus aurium. Fortschr Med. 1997;115:7-11.

Zusmmenfass JW. Ergebnissee in erplazebo kontrolliertern Doppel blind studiezur Therapie des Tinnitus mitdem Ginkgo-Extract Egb 761. Schwabe Arzneimittel Internal Report. 1998;21:7.

von Boetticher A. Gingko biloba extract in the treatment of tinnitus: a systematic review. Neuropsychiatr Dis Treat. 2011:441-7.