INTRATYMPANIC DEXAMETHASONE IN THE TREATMENT OF INTRACTABLE TINNITUS

Abstract

Objectives
To evaluate the effectiveness and safety of intratympanic dexamethasone in patients with intractable tinnitus who were unresponsive to conventional medical therapy, and to assess both objective clinical outcomes and subjective patient-reported improvements.

Methodology
This observational and interventional study was conducted in a CMH Gujranwala using a mixed-method approach. Patients with persistent tinnitus were selected through purposive sampling. Intratympanic dexamethasone was administered under aseptic conditions at regular intervals. Quantitative assessment included Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), frequency and duration of tinnitus episodes, and audiometric hearing thresholds. Pre- and post-treatment values were compared using paired t-tests. Qualitative data were collected through semi-structured interviews focusing on quality of life, sleep, emotional well-being, and patient satisfaction.

Results
The study demonstrated a statistically significant reduction in tinnitus severity, frequency, and distress following treatment (p < 0.05). Mean THI and VAS scores decreased markedly, with many patients shifting from moderate–severe to mild categories. Improvements were also observed in episode frequency, duration, and hearing thresholds. Qualitative findings revealed enhanced quality of life, improved sleep, reduced anxiety, and better concentration. Most patients reported moderate to complete relief, although a small proportion showed minimal or no improvement. The treatment was well tolerated with only minor, transient side effects.

Conclusion
Intratympanic dexamethasone is an effective and safe treatment modality for intractable tinnitus, providing both measurable clinical improvement and meaningful subjective relief. It may be considered a viable option for patients resistant to conventional therapies.