Randomised controlled clinical study to evaluate the efficacy of IV injection of caroverine and intratympanic steroid injection in the treatment of cochlear synaptic tinnitus with sensorineural hearing loss

Authors

  • Sharmila Dhulipalla Department of Otorhinolaryngology, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India
  • Radhika Sodadasu Department of Otorhinolaryngology, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20211572

Keywords:

Intratympanic injection, Caroverine injection, Tinnitus

Abstract

Background: Cochlear synaptic tinnitus with sensorineural hearing loss (SNHL) is the most common type of subjective tinnitus. Many therapies were tried, but nothing is well proven to cure this. Hence, our present study aims to assess the efficacy of intravenous (IV) injection of caroverine and intratympanic steroid injection in treatment of cochlear synaptic tinnitus with SNHL.

Methods: This study was carried out at the ear, nose and throat (ENT) department with 60 patients (22 male, 38 female) between the ages of 20 and 70 who had idiopathic tinnitus. Patients who met inclusion criteria were randomized by simple randomization and divided into two groups. The study group receives intratympanic dexamethasone, twice weekly for total three weeks and stat dose of IV caroverine. The control group receives an intratympanic isotonic solution with an IV caroverine placebo. Tinnitus handicap index (THI) score and pure tone averages (PTA) were done before treatment and in the first week, first month, and six months after completing the study protocol.  

Results: In the study group, pre-treatment results, and post-treatment first, sixth month THI scores, PTA results were different to a significant extent, whereas in the control group, the same scores were not different significantly. The THI scores between the groups revealed considerably lower scores in the first and six months for the study group. Successful treatment was defined as a decrease in PTA by 10 dB or more after six months.

Conclusions: The effect of the intratympanic injection of dexamethasone along with IV injection of caroverine on the efficacy of treatment of tinnitus severity and improving hearing was statistically significant.

References

Shiley SG, Folmer RL, McMenomey SO. Tinnitus and hyperacusis. In: Cummings CW, Flint PW, Harker LA, Haughey BH, Richardson MA, Robbins KT, et al., editors. Otolaryngol Head and Neck Surg. Philadelphia: Elsevier Mosby. 2005;2832-47.

Jastreboff PJ, Gray WC, Mattox DE. Tinnitus and hyperacusis. In: Cummings CW, editor. Otolaryngology Head and Neck Surgery. 3rd ed. Mosby-Year Book. 1998;3198-222.

Dodson KM, Sismanis A. Intratympanic perfusion for the treatment oftinnitus. Otolaryngol Clin North Am. 2004;37:991-1000.

Hoffer ME, Wester D, Kopke RD, Weisskopf P, Gottshall K. Transtympanic management of tinnitus. Otolaryngol Clin North Am. 2003;36:353-8.

Sakata E, Nakazawa H, Iwashita N. Therapy of tinnitus. Tympanic cavity infusion of lidocaine and steroid solution. Auris Nasus Larynx. 1984;11:11-8.

Cesarani A, Capobianco S, Soi D, Giuliano DA, Alpini D. Intratympanic dexamethasone treatment for control of subjective idiopathic tinnitus: our clinical experience. Int Tinnitus J. 2002;8:111-4.

Pitovski DZ, Drescher MJ, Drescher DG. Glucocorticoid receptors in the mammalian inner ear: RU 28362 binding sites. Hear Res. 1994;77:216-20.

Ten Cate WJ, Curtis LM, Small GM, Rarey KE. Localization of glucocorticoid receptors and glucocorticoid receptor mRNAs in the rat cochlea. Laryngoscope. 1993;103:865-71.

Blakley BW. Clinical forum: a review of intratympanic therapy. Am J Otolaryngol. 1997;18:520-6.

Shirwany NA, Seidman MD, Tang W. Effect of transtympanic injection ofsteroids on cochlear blood flow, auditory sensitivity, and histology in theguinea pig. Am J Otol. 1998;19:230-5.

Silverstein 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.

Ceranic GB, Luxon LM. Tinnitus and other dysacusis: Scott Brown’s Otorhinolaryngology and Head and Neck surgery. 7thEd. Great Britain: Hodder Arnold Ltd. 2008;3:3594-619.

Glutamate Brix R, Denk DM, Ehrenberger K. Neurophysiological control in therapy of tinnitus with cochlear disorders. In: Reich GE, Vernon JA (Eds). Proceedings of the V International Tinnitus Seminar 1995. Portland, OR: Scandinavian American Tinnitus Association. 1995;101-5.

Mc Combe A, Baguley D, Coles R, Mc Kenna L, Mc Kinney C, Windle-Taylor P. Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck surgeons, 999. Clin Otolaryngol. 2011;26:388-93.

Downloads

Published

2021-04-23

Issue

Section

Original Research Articles