The Efficacy of Intratympanic Steroid Injection in Tinnitus Cases Unresponsive to Medical Treatment

Abstract

The Journal of International Advanced Otology (J Int Adv Otol) is an international, peer reviewed, open access publication that is fully sponsored and owned by the European Academy of Otology and Neurotology and the Politzer Society. The journal is published triannually in April, August, and December and its publication language is English.The scope of the Journal is limited with otology, neurotology, audiology (excluding linguistics) and skull base medicine.The Journal of International Advanced Otology aims to publish manuscripts at the highest clinical and scientific level. J Int Adv Otol publishes original articles in the form of clinical and basic research, review articles, short reports and a limited number of case reports. Controversial patient discussions, communications on emerging technology, and historical issues will also be considered for publication.Target audience of J Int Adv Otol includes physicians and academics who work in the fields of otology, neurotology, audiology and skull base medicine.

Corticosteroids in Otorhinolaryngology

“…The addition of dexamethasone to melatonin therapy had a statistically significant effect on reducing tinnitus compared to melatonin alone [58]. Most articles on the subject conclude that intratympanic steroid injections are effective mostly in patients with acute tinnitus and mostly show no effect in those with chronic tinnitus [52,59]. The studies presented here primarily utilize dexamethasone as the drug administered to the patient; however, it is not the only substance used.…”

“…However, the scientific literature reports positive effects of steroid treatment of tinnitus, indicating that there is still a need for a broad investigation of the contribution of steroids to the treatment of tinnitus. In a study by Yaner et al a statistically significant parameter score was obtained indicating positive treatment effects with intratympanic dexamethasone versus placebo [52]. Subsequently, a study by Shim et al indicates the positivity of intratympanic injection of dexamethasone as an adjunctive treatment for tinnitus in patients treated with alprazolam [57].…”

“…According to the available literature, the therapeutic effect of drugs administered intratympanically occurs by diffusion through the round window, the annular ligament of the oval window, the capillaries, or through the lymphatic system of the inner ear. However, the effectiveness of intratympanic therapy in the treatment of tinnitus remains limited [51,52]. The American Academy of Otolaryngology guidelines provide detailed patient management criteria and outline pharmacologic treatment options for patients with varying levels of confidence and recommendations.…”

S3 Guideline: Chronic Tinnitus

“…Therapeutic approaches such as intratympanic steroid treatment do not affect chronic tinnitus [ 218 , 219 ] if it does not occur in conjunction with acute hearing loss. A temporary increase in tinnitus intensity and tinnitus distress is not considered new-onset tinnitus but should be considered and treated as a fluctuation in the subjective perception of chronic tinnitus [ 220 ].…”

“…Treatment outcome was measured with the Tinnitus Handicap Inventory (THI), before treatment, after 1 week, after 1 month and after 6 months. In this study, the verum-treated group showed an improvement in THI after 6 months compared to the control group, although only just marginally significant, while hearing thresholds did not improve with this treatment [ 219 ]. Other studies with a similar study design had not found any effects in the case of long-term tinnitus, but at best in the case of acute tinnitus.…”