Transtympanic dexamethasone treatment for control of subjective idiopathic Tinnitus

This study was done to evaluate the use of transtympanic dexamethasone treatment for control of idiopathic Tinnitus in normal hearing subjects and to determine the value of transient evoked otoacoustic emission [TEOAE] as an objective test for evaluation of the effect of this medication. 60 patient presented with tinnitus were divided into two groups, 30 patient as a study group received via ventilation tube dexamethasone hyaluranate [16 mg/ml] three times/week, every other day for a period of three months. The control group consisted of 30 patients also suffering tinnitus and received placebo. The age of each group was ranged between 20 and 50 years. All patient of the study and control group were subjected to full history as regard tinnitus, ENT examination and basic audiological evaluation [pure tone audiometry, narrow band audiometry and speech audiometry], Tinnitus matching tests and TEOAE test. All had normal peripheral hearing threshold level in spite of the presence of tinnitus. The examination were done for both study and control groups in three sessions. First evaluation was done before start of medications as a base line second evaluation after two months of treatment and third evaluation after three months at the end of treatment. The results showed no statistically significant difference in pure tone or narrow band audiometric threshold between the study and control groups after three months of medications. There was a statistically significant improvement in tinnitus matching test, [tinnitus loudness and minimal masking level] in the study group after the end of medications. Also their was statistically significant improvement in TEOAE findings [TEOAE amplitude and reproducibility and at each frequency in the study group when compared to control group at the second month and after the end of three months of treatment [80% pass response for TEOAE]. The subjective evaluation also showed 50% complete relief amid 34% change in character and intensity of tinnitus. It is concluded that Transtympanic Dexamethasone is an effective therapy for control of subjective tinnitus within three months and TEOAE test could be used as an objective test for evaluation of the effect of this medication on cochlear function in patient with subjective tinnitus

Transtympanic dexamethasone application in treatment of sudden idiopathic sensorineural hearing loss

This study was done to evaluate the effect of Transtympanic Dexamethasone in treatment of sudden idiopathic sensorineural hearing loss and to determine the value of transient evoked otoacoustic emission [TEOAE] as an objective test for evaluation of cochlear function improvement after this treatment. A total of 30 patients complaining of idiopathic sudden SNHL with age range between 20 and 50 years were examined. Full audiological evaluation was done including pure tone audiometry, speech audiometry and otoacoustic emission test were done.All patients had an average pure tone threshold between 45-65 dBHTL indicating mild to moderate SNHL mainly at high frequencies at the first evaluation before the start of treatment.The second evaluation was done after two months and the third evaluation after three months of treatment with Dexamethasone hyaluronate [16 mg/ml] using 0.2-0.4 ml at each injection daily for three months. There were significant improvement in pure tone threshold in 80% of patients and TEOAE results in 68% of patients at the third month of treatment. It is concluded that Transtympanic Dexamethasone treatment is an effective method for treatment of sudden idiopathic SNHL and that TEOAE test could be used as an objective method for evaluation of improvement in cochlear function after this treatment in patients with sudden idiopathic SNHL

Inner ear involvement in rheumatoid arthritis

This study was designed to determine the efficiency of the otoacoustic emission test in the early detection of inner ear involvement in rheumatoid arthritis [RA], the degree and type of hearing loss and to correlate the changes in inner ear function with the duration and activity of the disease. Thirty-five patients and ten healthy control subjects were included in the study. All were subjected to complete rheumatological, ENT, and audiological examination, including pure tone audiometry, speech audiometry, immittancemetry and transiently evoked otoacoustic emission [TEOAE] testing. It was found that there was a relatively significant difference between the hearing threshold of RA patients and controls. RA could result in either conductive or sensorineural hearing loss [SNHL]. In Group I of early RA, ten patients had normal hearing threshold but their TEOAE had significant diminished amplitude as 50% partially passed and 16.7% failed the test. In Group II with late RA there were 63.5% who failed and 25% who partially passed with only 12.5% who passed the TEOAE test. There was a significant positive correlation between the duration of the disease and the degree of inner ear involvement as determined by pure tone audiometry and TEOAE. No correlation was found between the activity of the disease or medications with the degree of inner ear involvement. TEOAE is considered a good method for early detection of inner ear involvement in RA