Clinical Experiences of Steroid Targeting Therapy to Inner Ear for Control of Tinnitus

We summarize our long-term clinical experiences with an inner-ear drug delivery system (DDS) for control of tinnitus. The inner-ear DDS consist of transtympanic perfusion of 2 or 4 mg dexamethasone to the round window via the middle ear. Therapeutic results of steroid targeting therapy to the inner ear were evaluated in 3,978 ears of 3,041 patients. Tinnitus improved in 75% of these patients immediately after treatment and in 68% after 6 months. The effects of such therapy on tinnitus varied depending on the underlying diseases. The improvement of tinnitus in the presence of labyrinthine hydrops was good, whereas the effects on noise- or drug-induced tinnitus were poor. Our results indicate that in high-tone tinnitus, the effects were poor, but they were good for low-pitched tinnitus. No correlation existed between the efficacy of management and loudness of the tinnitus. The dangers of perforating the eardrum and of inciting the discomfort of vertigo as a result of the transtympanic injection of dexamethasone are minimal. We believe that the transtympanic infusion technique is an effective DDS for control of inner-ear diseases and symptoms. This technique may be performed by any neurootologist in an outpatient clinic.