title: Intratympanic dexamethasone injections as a treatment for severe, disabling tinnitus: does it work?
abstract: OBJECTIVE
  To test the effectiveness of intratympanic dexamethasone injections as a treatment for severe disabling cochlear tinnitus.
  
  
  METHODS
  Randomized, prospective, single-blind study.
  
  
  METHODS
  Academic tertiary referral hospital.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Otolaryngology, Brasília University Medical School, Brasília, Brazil.
authors.forename: Mercedes F S
authors.initials: MF
authors.lastname: Araújo
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Oliveira
authors.forename: Fayez M
authors.initials: FM
authors.lastname: Bahmad
mesh_terms: D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D016037:Single-Blind Method; D014012:Tinnitus / Q000188:drug therapy*; D017211:Treatment Failure; D014432:Tympanic Membrane
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone