Intratympanic methylprednisolone injections for subjective tinnitus

Topak, Murat; Sahin-Yilmaz, Aslı; Ozdoganoglu, T; Yılmaz, Hüseyin; Özbay, Musa; Külekçi, Mehmet

doi:10.1017/s0022215109990685

Cited by 47 publications

(39 citation statements)

References 20 publications

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“…Three studies [13][14][15] compared ITSI to placebo and found no benefit in tinnitus score improvement. One study [16] compared intratympanic dexamethasone, intratympanic prednisolone and oral carbamazepine and found no benefit in the ITSI groups.…”

Section: Resultsmentioning

confidence: 99%

Intratympanic corticosteroids injections: a systematic review of literature

Lavigne

Saliba

2015

Eur Arch Otorhinolaryngol

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The objective of the study was to determine the evidence of intratympanic steroids injections (ITSI) for efficacy in the management of the following inner ear diseases: Ménière's disease, tinnitus, noise-induced hearing loss (NIHL) and idiopathic sudden sensorineural hearing loss (ISSNHL). The data sources were literature review from 1946 to December 2014, PubMed and Medline. A systematic review of the existing literature was performed. Databases were searched for all human prospective randomized clinical trials using ITSI in at least one treatment group. The authors identified 29 prospective randomized clinical trials investigating the benefits of an intratympanic delivery of steroids. Six articles on Ménière's disease were identified, of which one favored ITSI over placebo in vertigo control. Of the five randomized clinical trials on tinnitus therapy, one study found better tinnitus control with ITSI. The only available trial on NIHL showed significant hearing recovery with combination therapy (ITSI and oral steroids therapy). Seventeen studies were identified on ISSNHL, of which 10 investigated ITSI as a first-line therapy and 7 as a salvage therapy. Studies analysis found benefits in hearing recovery in both settings. Due to heterogeneity in treatment protocols and follow-up, a meta-analysis was not performed. Given the low adverse effects rates of ITSI therapy and good patient tolerability, local delivery should be considered as an interesting adjunct to the therapy of the ISSNHL and NIHL. Only one article over six where ITSI therapy offers potential benefits to patients with Ménière's disease in the control of tinnitus and vertigo was found. ITSI does not seem to be effective in the treatment of tinnitus.

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Section: Resultsmentioning

confidence: 99%

Intratympanic corticosteroids injections: a systematic review of literature

Lavigne

Saliba

2015

Eur Arch Otorhinolaryngol

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“…However, no controlled study has reported therapeutic results for tinnitus that extended beyond that of control. [9][10][11] These previous studies, however, did not consider symptom duration, and the majority of subjects had experienced tinnitus for more than 1 year. Steroid injection may not be effective beyond 1 year because cochlear lesions may not be reversible after this time.…”

Section: Introductionmentioning

confidence: 99%

Comparison of various treatment modalities for acute tinnitus

et al. 2011

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“…Local side effects, may include injection-site pain, dizziness, caloric vertigo, infection, persistent tympanic membrane perforation, or possible vasovagal or syncopal episodes during injection [14] [19] [46]. In our study no side-effects except for transient vertigo in few patients were noted.…”

Section: Discussionmentioning

confidence: 53%

“…Tympanopunction i.e. Direct injection of the drug into the middle ear or myringotomy first followed by endoscopic examination of round window region followed by injection [13] [14]. In our study tympanopunction was done and a slow and steady injection was found to be a feasible mode of delivering the drug.…”

Section: Discussionmentioning

confidence: 71%

Intratympanic Injections: An Unsolved Mystery

Parelkar¹,

Thorawade²,

Jagade³

et al. 2015

IJOHNS

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Aims: The aim of this study was to test the effectiveness of intratympanic dexamethasone injections as a treatment for severe disabling tinnitus and also observe its effect on hearing loss if any. Materials and Methods: Thirty patients with severe disabling tinnitus in the age group 20 to 60 years were selected and randomly assigned to receive intratympanic injections of a dexamethasone solution 4 mg/ml (0.5 ml) or isotonic saline (0.5 ml) solution under topical anaesthesia, once per week for 4 weeks using a zero degree endoscope. Improvement in tinnitus was assessed using a visual analog scale, considering 2-point improvement as significant and alteration in hearing if any was noted by pure tone audiometery before and after the therapy. Results: The improvement in tinnitus was not significant, with no alteration in audiometery reports. Conclusions: Intratympanic therapy is an attractive mode of treatment because of its highly targeted delivery, low concentration of the drugs required and a very good patient tolerance. Although there has been no breakthrough in intratympanic therapy for tinnitus or other otological conditions, accessibility to the inner ear through the semipermeable round window membrane holds many promises in the near future.

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Intratympanic methylprednisolone injections for subjective tinnitus

Abstract: The results of this study indicate that intratympanic methylprednisolone has no benefit, compared with placebo, for the treatment of subjective tinnitus of cochlear origin refractory to medical treatment.

Cited by 47 publications

References 20 publications

Intratympanic corticosteroids injections: a systematic review of literature

Intratympanic corticosteroids injections: a systematic review of literature

Comparison of various treatment modalities for acute tinnitus

Intratympanic Injections: An Unsolved Mystery

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