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