Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-24T11:33:40.752Z Has data issue: false hasContentIssue false
  • English
  • Français

Intratympanic methylprednisolone injections for subjective tinnitus

Published online by Cambridge University Press:  29 July 2009

M Topak ,
A Sahin-Yilmaz ,
T Ozdoganoglu ,
H B Yilmaz ,
M Ozbay  and
M Kulekci
M Topak
Affiliation:
Otolaryngology Clinic, Taksim Education and Research Hospital, Istanbul, Turkey
A Sahin-Yilmaz*
Affiliation:
Otolaryngology Clinic, Taksim Education and Research Hospital, Istanbul, Turkey
T Ozdoganoglu
Affiliation:
Otolaryngology Clinic, Taksim Education and Research Hospital, Istanbul, Turkey
H B Yilmaz
Affiliation:
Otolaryngology Clinic, Tuzla State Hospital, Istanbul, Turkey
M Ozbay
Affiliation:
Otolaryngology Clinic, Taksim Education and Research Hospital, Istanbul, Turkey
M Kulekci
Affiliation:
Otolaryngology Clinic, Taksim Education and Research Hospital, Istanbul, Turkey
*
Address for correspondence: Dr Asli Sahin-Yilmaz, Taksim Egitim ve Arastirma Hastanesi KBB Klinigi, Cihangir, 34433, Istanbul, Turkey. Fax: 90 212 2499890 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

This study aimed to determine whether intratympanically injected methylprednisolone is effective in treating subjective tinnitus refractory to medical treatment.

Study design:

Prospective, randomised, placebo-controlled, single-blinded study.

Methods:

Seventy adult patients with subjective tinnitus of cochlear origin were randomly assigned to receive intratympanic injection of either methylprednisolone or saline solution. The treatment protocol comprised three intratympanic injections, one per week for three weeks. Improvement in tinnitus severity was measured by a self-rated tinnitus loudness scale and by the tinnitus severity index, at baseline and two weeks after the last injection.

Results:

Data for 59 patients were available for analysis. There was no significant difference between the two treatment groups regarding age, sex, pure tone average, pretreatment tinnitus intensity, tinnitus laterality or tinnitus duration. There was a significant post-treatment improvement in self-rated tinnitus loudness scale results in both groups. No significant post-treatment changes in the tinnitus severity index individual and total scores were observed in either group. The most frequently encountered side effects were pain during injection, vertigo, a burning sensation around the ear and in the throat, and a bitter taste. A burning sensation and bitter taste were observed more often in the methylprednisolone group compared with the placebo group

Conclusion:

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.

Keywords

MethylprednisoloneTinnitus
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 11 , November 2009 , pp. 1221 - 1225
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented orally at the 30th Turkish National Congress of Otorhinolaryngology Head and Neck Surgery, 8–12 October 2008, Antalya, Turkey.

References

1Shiley, SG, Folmer, RL, McMenomey, SO. Tinnitus and hyperacusis. In: Cummings, CW, Flint, PW, Harker, LA, Haughey, BH, Richardson, MA, Robbins, KT et al. , eds. Otolaryngology Head and Neck Surgery. Philadelphia: Elsevier Mosby, 2005;2832–47Google Scholar
2Hoffer, ME, Wester, D, Kopke, RD, Weisskopf, P, Gottshall, K. Transtympanic management of tinnitus. Otolaryngol Clin North Am 2003;36:353–8CrossRefGoogle ScholarPubMed
3Alleva, M, Loch, WE, Paparella, MM. Tinnitus. Prim Care 1990;17:289–97CrossRefGoogle ScholarPubMed
4Dodson, KM, Sismanis, A. Intratympanic perfusion for the treatment of tinnitus. Otolaryngol Clin North Am 2004;37:991–1000CrossRefGoogle ScholarPubMed
5Pitovski, DZ, Drescher, MJ, Drescher, DG. Glucocorticoid receptors in the mammalian inner ear: RU 28362 binding sites. Hear Res 1994;77:216–20CrossRefGoogle ScholarPubMed
6ten Cate, WJ, Curtis, LM, Small, GM, Rarey, KE. Localization of glucocorticoid receptors and glucocorticoid receptor mRNAs in the rat cochlea. Laryngoscope 1993;103:865–71CrossRefGoogle ScholarPubMed
7Shirwany, NA, Seidman, MD, Tang, W. Effect of transtympanic injection of steroids on cochlear blood flow, auditory sensitivity, and histology in the guinea pig. Am J Otol 1998;19:230–5Google ScholarPubMed
8Parnes, LS, Sun, AH, Freeman, DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 1999;109:1–17CrossRefGoogle ScholarPubMed
9Sakata, E, Itoh, A, Itoh, Y. Treatment of cochlear tinnitus with dexamethasone infusion into the tympanic cavity. Int Tinnitus J 1996;2:129–35Google ScholarPubMed
10Silverstein, H, Isaacson, JE, Olds, MJ, Rowan, PT, Rosenberg, S. Dexamethasone inner ear perfusion for the treatment of Meniere's disease: a prospective, randomized, double-blind, crossover trial. Am J Otol 1998;19:196–201Google ScholarPubMed
11Araújo, MF, Oliveira, CA, Bahmad, FM Jr.Intratympanic dexamethasone injections as a treatment for severe, disabling tinnitus: does it work? Arch Otolaryngol Head Neck Surg 2005;131:113–17CrossRefGoogle ScholarPubMed
12Silverstein, H, Choo, D, Rosenberg, SI, Kuhn, J, Seidman, M, Stein, I. Intratympanic steroid treatment of inner ear disease and tinnitus (preliminary report). Ear Nose Throat J 1996;75:468–71, 474, 476CrossRefGoogle ScholarPubMed
13Barrs, DM. Intratympanic corticosteroids for Meniere's disease and vertigo. Otolaryngol Clin North Am 2004;37:955–72CrossRefGoogle ScholarPubMed
14Rarey, KE, Curtis, LM. Receptors for glucocorticoids in the human inner ear. Otolaryngol Head Neck Surg 1996;115:38–41CrossRefGoogle ScholarPubMed
15Schaaf, MJ, Cidlowski, JA. Molecular mechanisms of glucocorticoid action and resistance. J Steroid Biochem Mol Biol 2002;83:37–48CrossRefGoogle ScholarPubMed
16Banerjee, A, Parnes, LS. The biology of intratympanic drug administration and pharmacodynamics of round window drug absorption. Otolaryngol Clin North Am 2004;37:1035–51CrossRefGoogle ScholarPubMed
17Fukushima, M, Kitahara, T, Uno, Y, Fuse, Y, Doi, K, Kubo, T. Effects of intratympanic injection of steroids on changes in rat inner ear aquaporin expression. Acta Otolaryngol 2002;122:600–6CrossRefGoogle ScholarPubMed
18Haynes, DS, O'Malley, M, Cohen, S, Watford, K, Labadie, RF. Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy. Laryngoscope 2007;117:3–15CrossRefGoogle ScholarPubMed
19Battista, RA. Intratympanic dexamethasone for profound idiopathic sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2005;132:902–5CrossRefGoogle ScholarPubMed
20Xenellis, J, Papadimitriou, N, Nikolopoulos, T, Maragoudakis, P, Segas, J, Tzagaroulakis, A et al. Intratympanic steroid treatment in idiopathic sudden sensorineural hearing loss: a control study. Otolaryngol Head Neck Surg 2006;134:940–5CrossRefGoogle ScholarPubMed
21Sennaroglu, L, Sennaroglu, G, Gursel, B, Dini, FM. Intratympanic dexamethasone, intratympanic gentamicin, and endolymphatic sac surgery for intractable vertigo in Meniere's disease. Otolaryngol Head Neck Surg 2001;125:537–43CrossRefGoogle ScholarPubMed
22Shulman, A, Goldstein, B. Intratympanic drug therapy with steroids for tinnitus control: a preliminary report. Int Tinnitus J 2000;6:10–20Google ScholarPubMed
23Sakata, E, Ito, Y, Itoh, A. Clinical experiences of steroid targeting therapy to inner ear for control of tinnitus. Int Tinnitus J 1997;3:117–21Google ScholarPubMed
24Kaltenbach, JA, Afman, CE. Hyperactivity in the dorsal cochlear nucleus after intense sound exposure and its resemblance to tone-evoked activity: a physiological model for tinnitus. Hear Res 2000;140:165–72CrossRefGoogle ScholarPubMed