Intratympanic dexamethasone injection for refractory tinnitus: prospective placebo-controlled study.

Abstract

OBJECTIVES/HYPOTHESIS: The purpose of this study is to investigate the effectiveness of intratympanic dexamethasone injections (ITDI) for refractory tinnitus. STUDY DESIGN: A prospective, placebo-controlled, randomized, double-blind study. METHODS: Thirty patients with refractory tinnitus who were diagnosed in the Department of Otolaryngology, Ajou University Hospital, Suwon, Republic of Korea, between 2006 and 2007 were enrolled and then were assigned into two groups of ITDI (15 patients) or saline (15 patients) by permuted block randomization. Intratympanic injections were double-blind performed four times within 2 weeks. After 4 weeks, we analyzed the improvement and aggravation rates of tinnitus using the following parameters: questionnaires, tinnitus handicap index (THI), loudness matching test, frequency, and duration of tinnitus. RESULTS: The effectiveness rates of ITDI for refractory tinnitus reported in the tinnitus questionnaires, in the THI, and in the loudness matching test were all 33.3% in the steroid group, and 26.7%, 40.0%, and 26.7% in the saline group, respectively. However, there were no statistically significant differences in both groups. To analyze the therapeutic effect of ITDI on tinnitus under 6 months of its development, the improvement rates reported in the tinnitus questionnaires, in the THI, and in the loudness matching test were all 28.5% in the steroid group, and 40.0%, 40.0%, and 30.0% in the saline group, respectively. There were also no statistically significant differences in both groups. CONCLUSIONS: ITDI may not be effective for refractory tinnitus. The indication of ITDI for tinnitus needs to be limited to specific cases.