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Intratympanic Dexamethasone Injections as a Treatment for Severe, Disabling Tinnitus
Does It Work?
Mercedes F. S. Araújo, MD, MSc;
Carlos A. Oliveira, MD, PhD;
Fayez M. Bahmad, Jr, MD
Arch Otolaryngol Head Neck Surg. 2005;131:113-117.
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.
Author Affiliations: Department of Otolaryngology, Brasília University Medical School, Brasília, Brazil.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Psychological Factors in Severe Disabling Tinnitus
Langenbach
Arch Otolaryngol Head Neck Surg 2005;131:829-829.
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