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Intratympanic methylprednisolone acetate versus intratympanic lidocaine in the treatment of idiopathic subjective unilateral tinnitus of less than 1-year duration: a randomized, double-blind, clinical trial

Abstract

Background

Tinnitus, which can persist for many years, usually affects the quality of life. Tinnitus is challenging to manage with a variety of options including psychotherapy and pharmacological treatment. Intratympanic (IT) injections of steroids or lidocaine (LD) are two of the pharmacological treatment options used in the treatment of idiopathic tinnitus.

Objective

The aim of the study was to evaluate the efficacy and safety of IT-methylprednisolone acetate (MPA) versus IT-LD in the treatment of idiopathic subjective unilateral tinnitus of less than 1-year duration.

Participants and methods

In this randomized, double-blind, clinical study, 46 people who had been diagnosed with idiopathic subjective unilateral tinnitus were randomly divided into two groups and treated with IT-MPA acetate or IT-LD, accordingly. Improvement was evaluated in both groups 3 months after the injections and then again after 1 year. Safety was evaluated by recording the side effects of the injections.

Results

At 3 months after the injections, the mean improvement rates (using visual analog scale) were 56.5% in the MPA group and 47.8% in the LD group. After 1 year, this declined to 30.4 and 26.1%, respectively. The difference in improvement was not statistically significant. The side effects were all minor, and were primarily reported after LD injection.

Conclusion

IT injections of MPA and LD result in moderate improvement in tinnitus, but no statistically significant differences between these treatments were found.

References

  1. 1

    Lockwood AH, Salvi RJ, Burkard RF. Tinnitus. N Engl J Med 2002; 347:904–910.

    Article  Google Scholar 

  2. 2

    Langguth B, Elgoyhen AB. Current pharmacological treatments for tinnitus. Expert Opin Pharmacother 2012; 13:2495–2509.

    CAS  Article  Google Scholar 

  3. 3

    Zoger S, Svedlund J, Holgers KM. Psychiatric disorders in tinnitus patients without severe hearing impairment: 24 month follow-up of patients at an audiological clinic. Audiology 2001; 40:133–140.

    CAS  Article  Google Scholar 

  4. 4

    Shim HJ, Jun Song S, Choi AY, Hyung Lee R, Won Yoon S. Comparison of various treatment modalities for acute tinnitus. Laryngoscope 2011; 121:2619–2625.

    Article  Google Scholar 

  5. 5

    Kim JI, Choi JY, Lee DH, Choi TY, Lee MS, Ernst E. Acupuncture for the treatment of tinnitus: a systematic review of randomized clinical trials. BMC Complement Altern Med 2012; 12:97.

    Article  Google Scholar 

  6. 6

    Choi SJ, Lee JB, Lim HJ, In SM, Kim JY, Bae KH, Choung YH. Intratympanic dexamethasone injection for refractory tinnitus: prospective placebo-controlled study. Laryngoscope 2013; 123: 2817–2822.

    CAS  Article  Google Scholar 

  7. 7

    Lefebvre PP, Staecker H. Steroid perfusion of the inner ear for sudden sensorineural hearing loss after failure of conventional therapy: a pilot study. Acta Otolaryngol 2002; 122:698–702.

    CAS  Article  Google Scholar 

  8. 8

    Slattery WH, Fisher LM, Iqbal Z, Friedman RA, Liu N. Intratympanic steroid injection for treatment of idiopathic sudden hearing loss. Otolaryngol Head Neck Surg 2005; 133:251–259.

    Article  Google Scholar 

  9. 9

    El-Hennawi DM, El-Deen MHB, Abou-Halawa AS, Nadeem HS, Ahmed MR. Efficacy of intratympanic methylprednisolone acetate in treatment of drill-induced sensorineural hearing loss in guinea pigs. J Laryngol Otol 2005; 119:2–7.

    Article  Google Scholar 

  10. 10

    Sakata E, Umeda Y. Treatment of tinnitus by transtympanic infusion. Auris Nasus Larynx 1976; 3:133–138.

    Article  Google Scholar 

  11. 11

    Sakata H, Kojima Y, Koyama S, Furuya N, Sakata E. Treatment of cochlear tinnitus with transtympanic infusion of 4% lidocaine into the tympanic cavity. Int Tinnitus J 2001; 7:46–50.

    CAS  PubMed  Google Scholar 

  12. 12

    Coles RR, Thompson AC, O’Donoghue GM. Intra-tympanic injections in the treatment of tinnitus. Clin Otolaryngol Allied Sci 1992; 17:240–242.

    CAS  Article  Google Scholar 

  13. 13

    Cesarani A, Capobianco S, Soi D, Giuliano DA, Alpini D. Intratympanic dexamethasone treatment for control of subjective idiopathic tinnitus: our clinical experience. Int Tinnitus J 2002; 8:111–114.

    CAS  PubMed  Google Scholar 

  14. 14

    Henry JA, Meikle MB. Psychoacoustic measures of tinnitus. J Am Acad Audiol 2000; 11:138–155.

    CAS  Google Scholar 

  15. 15

    She W, Dai Y, Du X, Chen F, Ding X, Cui X. Treatment of subjective tinnitus: a comparative clinical study of intratympanic steroid injection vs. oral carbamazepine. Med Sci Monit 2009; 15:PI35–PI39.

    CAS  PubMed  Google Scholar 

  16. 16

    Araujo MF, Oliveira CA, Bahmad FM. Intratympanic dexamethasone injections as a treatment for severe, disabling tinnitus: does it work?. Arch Otolaryngol Head Neck Surg 2005; 131:113–117.

    Article  Google Scholar 

  17. 17

    Yilmaz I, Yilmazer C, Erkan AN, Aslan SG, Ozluoglu LN. Intratympanic dexamethasone injection effects on transient-evoked otoacoustic emission. Am J Otolaryngol 2005; 26:113–117.

    CAS  Article  Google Scholar 

  18. 18

    Podoshin L, Fradis M, David YB. Treatment of tinnitus by intratympanic instillation of lignocaine (lidocaine) 2 per cent through ventilation tubes. J Laryngol Otol 1992; 106:603–606.

    CAS  Article  Google Scholar 

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Correspondence to Mohamed R. Ahmed.

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El Hennawi, D.E.D.M., Ahmed, M.R., Abdelkafy, W. et al. Intratympanic methylprednisolone acetate versus intratympanic lidocaine in the treatment of idiopathic subjective unilateral tinnitus of less than 1-year duration: a randomized, double-blind, clinical trial. Egypt J Otolaryngol 33, 564–568 (2017). https://doi.org/10.4103/ejo.ejo_4_17

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Keywords

  • intratympanic injection
  • lidocaine
  • methylprednisolone acetate
  • tinnitus