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Prognostic Factors for the Outcomes of Intratympanic Dexamethasone in the Treatment of Acute Subjective Tinnitus

An, Yong-Hwi; Yu, Kwang-Kyu; Kwak, Min Young; Yoon, Sang Won; Shim, Hyun Joon

doi: 10.1097/MAO.0000000000000526
Sensorineural Hearing Loss & Tinnitus
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Objective To determine the prognostic factors for the outcomes of treating acute subjective tinnitus with intratympanic dexamethasone (ITD).

Study Design Retrospective chart review.

Setting Tertiary referral center.

Patients We enrolled 139 subjects who were treated with ITD for acute subjective tinnitus with symptoms lasting for 3 months or less. Overall, 114 of 139 subjects completed questionnaires 3 months after treatment or fully recovered within 3 months. Audiograms were performed 3 months after treatment in 43 patients.

Intervention ITD for acute subjective tinnitus.

Main Outcome Measure Quantitative assessment of the severity of tinnitus by questionnaires and changes in hearing thresholds at all frequencies by pure-tone audiometry.

Results Tinnitus was cured in 43 of 114 patients (37.7%) within 3 months. The mean tinnitus loudness score, the mean tinnitus awareness score, and the mean tinnitus handicap inventory score were significantly reduced at 3 months after ITD. Audiometric responses were detected in 12 of 43 patients (27.9%) who underwent follow-up audiograms. The cure rate was significantly greater in patients with symptoms lasting for 2 weeks or less than in patients with symptoms lasting for more than 1 month (64.7% vs. 15.7%; p < 0.05). The mean global improvement index for tinnitus was significantly greater in patients with unilateral tinnitus than in patients with bilateral tinnitus (6.2 ± 1.9 vs. 5.0 ± 2.0; p < 0.05). Among patients with unilateral tinnitus, the audiometric response rate was significantly greater in patients with asymmetric hearing threshold than in patients with symmetric hearing threshold (48.8% vs. 4.8%; p < 0.01). The cure rate was significantly associated with the duration of symptoms. Unilateral tinnitus and audiologic asymmetry were positively associated with the audiometric response rate.

Conclusions The duration of symptoms affected the cure rate of ITD for acute subjective tinnitus. Unilateral tinnitus was associated with better improvements in symptoms than bilateral tinnitus. Furthermore, unilateral tinnitus and audiologic asymmetry were positively associated with the audiometric response.

Department of Otorhinolaryngology–Head and Neck Surgery, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea

Address correspondence and reprint requests to Hyun Joon Shim, M.D., Ph.D., Department of Otorhinolaryngology–Head and Neck Surgery, Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-Ro, Nowongu, Seoul 139-711, Korea. E-mail: eardoc11@naver.com

The authors disclose no conflicts of interest.

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