Abstract
Subjective tinnitus is an awareness of a phantom sound which is audible solely to the individual. Intra-tympanic steroid injections especially dexamethasone 8mg/ml have been used with variable success in relieving it; however this desired concentration is unavailable in India. The aim of this study was to assess the comparative efficacy of intra-tympanic methylprednisolone injections in different concentrations in subjective cochlear tinnitus. Ninety patients with complaint of abnormal ringing in uni/bilateral ear, with/without hearing loss were enrolled from our outpatient set-up. After written informed consent, the participants received a tinnitus loudness and frequency matching test. They were randomly assigned into three different subgroups (each with 30 patients) by a single-blind method.0.5ml of 40mg/ml concentration methylprednisolone solution was injected intratympanically in study set one (Group A), 125mg/ml in second set (Group B) and 250mg/ml in the third set (Group C). The groups were compared in terms of subjective tinnitus intensity and loudness matching after the intervention. On subjective analysis of tinnitus intensity 1 patient of Group A and 2 each of groups B and C demonstrated improvement. On loudness matching test for tinnitus, no patient in Group A was cured, though 3 each in groups B and C were cured. In the present study, no significant change was observed in the three treatment groups in subjective analysis of tinnitus intensity based on questionnaire. Similarly a non-significant response was obtained in loudness matching test for tinnitus. The intra-tympanic methylprednisolone injection gave suboptimal and inconsistent results at varying concentrations. Further prospective studies to evaluate the effect of intratympanic methylprednisolone on tinnitus are warranted in carefully selected group of patients.
Highlights
Subjective tinnitus is an awareness of a phantom sound which is audible solely to the individual
A detailed relevant history, general physical and otorhinolaryngological examination, microscopic examination, hearing tests and imaging studies (Computed Tomogram or Magnetic Resonance Imaging) of the selected patients was done.In every patient, after detailed history and its correlation with audiological tests, the clinical diagnosis of subjective cochlear tinnitus was conclusively proved.Tone decay was the topodiagnostic test used in our study
The study population consisted of 90 participants, of which 67 were males and 23 females; gender ratio 2.9/1. 49 patients were above 60 years of age, 32, 7 and 2 belonged to 40-60, 20-40 and less than 20 years respectively (Figure 1)
Summary
Subjective tinnitus is an awareness of a phantom sound which is audible solely to the individual. The participants received a tinnitus loudness and frequency matching test They were randomly assigned into three different subgroups (each with 30 patients) by a single-blind method.0.5ml of 40mg/ml concentration methylprednisolone solution was injected intratympanically in study set one (Group A), 125mg/ml in second set (Group B) and 250mg/ml in the third set (Group C). Maximum cases of tinnitus have a hearing loss, it can present with a normal hearing capacity.[1] Subjective tinnitus (ST) is a conscious awareness of a phantom sound, which only the patients are able to hear It is generally by virtue of cochlear pathology, such as presbyacusis, endolymphatic hydrops and noise induced hearing loss, any component in whole auditory pathway may be involved.[2]
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