Intratympanic dexamethasone injections as a treatment for severe, disabling tinnitus: does it work?
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.
Araújo
Mercedes F S
MF
Department of Otolaryngology, Brasília University Medical School, Brasília, Brazil.
Oliveira
Carlos A
CA
Bahmad
Fayez M
FM
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
D005938:Glucocorticoids; D003907:Dexamethasone