Efficacy of Trimetazidine Dihydrochloride for Relieving Chronic Tinnitus: A Randomized Double-Blind Study

OBJECTIVES: To evaluate the efficacy of trimetazidine dihydrochloride as a treatment for chronic tinnitus. METHODS: A total of 97 chronic tinnitus patients were evaluated in this randomized, prospective, double-blind, placebo-controlled trial. After assessing for eligibility, 82 patients were randomly assigned into placebo or trimetazidine groups according to the medication. The trimetazidine group received 20×3 mg/day per oral trimetazidine dihydrochloride and the placebo group received 20×3 mg/day per oral placebo for 3 months. Tinnitus handicap inventory (THI), visual analogue scale (VAS) questionnaires and audiometric results were used to determine the effectiveness of trimetazidine treatment. RESULTS: The study group comprised 82 tinnitus subjects, 42 (51%) of whom received trimetazidine dihydrochloride and 40 (49%) who received placebo. There was no significant difference between placebo and trimetazidine groups in THI grade and VAS (both pre- and posttreatment scores) (P>0.05) and no significant improvement was observed in subjective loudness score in either group (P>0.05). Additionally there was no significant difference between groups in pre- and posttreatment pure tone hearing thresholds at all measured frequencies (P>0.05). CONCLUSION: Trimetazidine dihydrochloride therapy was ineffective for relieving chronic tinnitus.

Reconstruction of the Orbit With a Temporalis Muscle Flap After Orbital Exenteration

OBJECTIVES: This study presents the role of the temporalis muscle flap in primary reconstruction after orbital exenteration. METHODS: A retrospective nonrandomized study of orbital exenterations performed between 1990 and 2010 for malignant tumors of the skin, paranasal sinus, and nasal cavity is presented. RESULTS: The study included 13 patients (nine men, four women; age range, 30-82 years) with paranasal sinus, nasal cavity, or skin carcinomas. Primary reconstruction of the cavity was performed in all patients after orbital exenteration. No visible defects in the muscle flap donor site were present. Local recurrences were readily followed up with nasal endoscopy, whereas radiology helped to diagnose intracranial involvement in three patients. Two patients died of systemic metastases and five died for other reasons CONCLUSION: The temporalis muscle flap is readily used to close the defect after orbital exenteration, and does not prevent the detection of recurrence.

effects of prostaglandins and leukotrienes on pathogenesis of otitis media

Among different inflammatory mediators. It is known that prostaglandins and leukotriens have an important role in pathogenesis of otitis media. In our study, chronic otitis media was induced by Streptococcus pneumonia in rats. Animals were divided into two groups. In the first group histopathologic examination, prostaglandin E[2] and LTB[4] measurements were made. In the second group, aspirin was injected I.M. and the same procedures were performed. The control group was not injected. In the histopathologic studies, hyperplasia, and increase in goblet cells, edema in subepithelial space, monomuclear cell infiltration, increased vascularity, periosteal reaction and bone erosion were observed. There were increased levels of PGE[2] and LTB[4] in both groups when compared with controls. Their levels were reduced after aspirin. We conclude that nonsteroidal anti-inflammatory drugs retard the development and the progression of chronic otitis media