1. CLINICAL STUDY OF EFFECTS OF INJ.CAROVERINE AND GINKGO BILOBA EXTRACT IN COMHLEAR SYNPATIC TINNITUS

Abstract

Tinnitus (ringing in the ear), is the most common problem encountered in every day of otolaryngology practices. Considerable variations exist in tinnitus prevalence with gender and age. It affects patient's life-style, general health as well as emotional status. The most common variety of tinnitus, cochlear synaptic tinnitus is diagnosed with the help of various audiological tests. There is no standardised treatment till date yet Tinnitus Retraining Therapy, medical therapy in form of psychotherapy or pharmacological therapy are commonly used one. Ginko biloba extract suggest greater and faster relief as compared to placebo. Recently Caroverine, a spasmolytic drug, having glutamate antagonistic activity is used for Tinnitus treatment. A randomised comparative study was designed to establish effects of Caroverine and Ginko biloba extract in treatment of Cochlear Synaptic Tinnitus. METHOD: 86 diagnosed patients of cochlear synaptic Tinnitus were treated with Inj Caroverine (group 1, n=22) and placebo (group 2, n=21), Ginkgo biloba extract ( group 3, n=22) and placebo (group 4, n=21) and followed up at 1 month ,3 months and 6 months and improvements were evaluated in terms of Tinnitus Grading and Tinnitus Matching. Statistical analysis was done using statistical software SPSS. The baseline profile and any improvement after treatment between groups were compared using paired/ANOVA test. RESULT: In our study 54.4% (12 out of 22.) patients responded immediately after infusion of Caroverine and remained effective at end of 1,3 and 6 months after drug infusion while 13.6% (3 out of 21) patients responded in placebo group and reverted back to pretreatment level on subsequent follow ups. In Ginkgo biloba group 31.8% (7 out of 22) patients responded at one month followup, while none responded in placebo group. These responders showed further improvement in Tinnitus Matching and Tinnitus Grading at 3 months but a plateau occurred at followup at 6 month without further improvement. Two patients were cured in group 3 (Gingko biloba). CONCLUSION: Caroverine immediately improves tinnitus grading and matching and provides immediate relief in reducing the severity of tinnitus. Ginkgo biloba extract takes longer time to improve tinnitus but it provides greater relief on long term follow-up It is finally suggested that inj. Caroverine should be given in severe cases of tinnitus to reduce its severity immediately and then patient should be put on Ginkgo biloba extract for a period of 3 months to provide sustained and long lasting relief. KEY WORDS: Cochlear Synaptic Tinnitus, Tinnitus Matching. Tinnitus Grading, Caroverine, Ginko biloba.