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Arch Otolaryngol Head Neck Surg. 2005 Feb;131(2):113-7.

Intratympanic dexamethasone injections as a treatment for severe, disabling tinnitus: does it work?

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  • 1Department of Otolaryngology, Brasília University Medical School, Brasília, Brazil.

Abstract

OBJECTIVE:

To test the effectiveness of intratympanic dexamethasone injections as a treatment for severe disabling cochlear tinnitus.

DESIGN:

Randomized, prospective, single-blind study.

SETTING:

Academic tertiary referral hospital.

PATIENTS:

Thirty-six patients with severe disabling tinnitus predominantly of cochlear origin were randomly assigned to receive intratympanic injections of a dexamethasone solution or isotonic sodium chloride (saline) solution.

INTERVENTIONS:

Under topical anesthesia and after randomization, 36 patients received 0.5-mL intratympanic injections once per week for 4 weeks of either a 4-mg/mL dexamethasone solution or saline solution. Five patients were excluded from analysis because they did not complete the treatment or did not return for follow-up.

MAIN OUTCOME MEASURE:

Improvement of tinnitus measured with a visual analog scale.

RESULTS:

The 2 groups were similar in age, sex, tinnitus laterality, measurement of tinnitus intensity on the visual analog scale, and main otologic diagnosis. We considered a 2-point improvement on the visual analog scale to be significant. Twenty-nine percent of the ears in the saline group and 33% of the ears in the dexamethasone group showed significant improvement immediately after completion of treatment. These measurements were not significantly different from each other. Follow-up varied from 13 to 31 months, and the patients with improved tinnitus returned to the initial measurements over time.

CONCLUSIONS:

There was no advantage in intratympanic injections of dexamethasone over saline solution in the treatment of severe, disabling tinnitus. Both solutions produced a placebolike improvement.

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