Comparison of various treatment modalities for acute tinnitus

• Published in: The Laryngoscope 2011-12, Vol.121 (12), p.2619-2625
• Main Authors: Shim, Hyun Joon, Jun Song, Seong, Choi, A Young, Hyung Lee, Rae, Won Yoon, Sang
• Format: Article
• Language: English
• Subjects: Acute Disease; Administration, Oral; Adult; Aged; alprazolam; Alprazolam - administration & dosage; Alprostadil - administration & dosage; Analysis of Variance; Biological and medical sciences; Bones, joints and connective tissue. Antiinflammatory agents; dexamethasone; Dexamethasone - administration & dosage; Double-Blind Method; Drug Therapy, Combination; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Follow-Up Studies; Humans; injection; Injections, Intralesional; Injections, Intravenous; Level of Evidence: 1b; Male; Medical sciences; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pharmacology. Drug treatments; Prospective Studies; prostaglandin E1; Reference Values; Risk Assessment; Severity of Illness Index; Tinnitus; Tinnitus - diagnosis; Tinnitus - drug therapy; Treatment Outcome; Tympanic Membrane - drug effects
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.22350

Objectives/Hypothesis: Because in most cases the development of tinnitus is triggered by cochlear damage, there exists the opportunity to eliminate tinnitus while the cochlear lesion is still reversible. Therefore, we evaluated the therapeutic effects of various treatment modalities on acute subjective idiopathic tinnitus (SIT) and investigated prognostic factors affecting the treatment outcome. Study Design: Prospective, controlled, double‐blind trial. Methods: A total 107 patients who underwent treatment for unilateral SIT that had developed within the previous 3 months completed the study. The patients were randomly assigned into three groups according to the treatment modality: group I (n = 32), alprazolam orally for 3 months; group II (n = 35), as for group I plus four intratympanic dexamethasone (ITD) injections; and group III (n = 40), as for group II plus four intravenous injections of lipo‐prostaglandin E1. Results: The improvement rate of group II (75.8%) was significantly higher than that of group I (40.3%; P < .05), and there was no significant difference in the improvement rate of group III (50.0%) compared with groups I and II (P > .05). The cure rates of group II (25.8%) and group III (20.0%) were significantly higher than that of group I (9.8%; P < .05). There was a significant correlation between the cure rate and duration of symptoms. Conclusions: The results of the present study indicate that ITD injection plus alprazolam medication is the best treatment choice for acute SIT within 3 months of development. Laryngoscope, 121:2619–2625, 2011