Intratympanic Dexamethasone Injections Greatly Helped My Tinnitus

I have had reactive tinnitus for 15 years. It went away after 8 or 9 years till I went to another concert which was not that loud, but my earplugs were not sealed properly. That did it. My tinnitus went crazy again. Never resolved back to zero but there were some good years. Every time flare ups after some loud noise.

A week ago at a party I did a card trick to two girls and they both screamed at my face so loud. Stupid me, I stood there like a deer in the headlights. I should have run or put my fingers in my ears. I was on death row for the next few days unable to live my life.

I know an ENT doctor in Houston who does intratympanic dexamethasone injections. I did it Thursday and my left ear was ringing like crazy on the way home and during that night.

I woke up Friday and could not believe it. My tinnitus went from a 7-8/10 to a 1-2/10. There is a favorable study from India and Egypt but the research says it works no better than Saline. I almost did not do the injection.

It worked. I had to purchase the dexamethasone from a compound pharmacy and take it with me to the doctor.

I know lots more about this. I just hope it last. Some recommend a series of injections but I think I am going to stick to one for now. Not too bad a procedure. Some burning when the dexamethasone goes in.

P.S. I have never posted on a forum like this, and I often see sad and bad stories, so I wanted to post a good one.

Research intratympanic dexemethesone injections for tinnitus. The Indian folks claim over a 70% positive response. I will see what tomorrow brings.

Sincerely,
Larry

 

Just the story I needed.

Just when I didn’t think my tinnitus could get any louder... It doubled, and has been this way for an hour now.

 

Hang on though – it went away spontaneously after eight or nine years by itself? How loud was it during the eight or nine years? Did the fading happen gradually? @PeteJ

 

HI @Larry Feingersh

Your Reactive tinnitus is actually Hyperacusis and needs treatment if you want it to improve. You need to see a Hearing Therapist or Audiologist that specialises in tinnitus and hyperacusis treatment and management. If you use headphones even at low volume then I advise you to stop using them. Please click on the links below and read my posts.

All the best
Michael

https://www.tinnitustalk.com/threads/new-to-tinnitus-what-to-do.12558/
https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

 

I have been beating this drum. The BTA claims on their site that it doesn't help despite scientific studies that show it does. It tastes like burning tires when it goes down your eustachian tubes.

 

Larry if you don’t mind, I just pmed you. I hope you see this and haven’t completely disappeared @Larry Feingersh

Or if you could share more info on which doctor this was?

 

Not much interest in this thread? The intratympanic Dexamethasone injections literally cured him. Crazy.

 

There are some semi-encouraging studies out there involving Dexamethasone. My otologist wasn't willing to do more than one because my hearing loss is only mild and I didn't press the issue. I do keep it in mind though:

The Efficacy of Intratympanic Steroid Injection in Tinnitus Cases Unresponsive to Medical Treatment

Comparison of Long-Term Outcome of Intratympanic Dexamethasone Therapy between Acute Noise-Induced Tinnitus and Acute Idiopathic Tinnitus

Efficacy of pharmacologic treatment in tinnitus patients without specific or treatable origin: A network meta-analysis of randomised controlled trials

 

Thanks for finding these. Dexamethasone injection sounds really promising but I'm too scared to bite the bullet.

 

It was no big deal at all. Biggest challenge will be finding someone to do it.

 

I didn't realize you had it done. How was the process, I'd love to hear your experience? Did you get much benefit from it, and how long did it last?

 

Sure did, about 5-6 weeks into my acute onset. I’m not sure what effect it had, but my tinnitus loudness is much less now 3 months later than it was, and my hearing levels improved from moderate hearing loss to mild/normalish at 8 kHz. That may have been my course with or without the injection. I do gather that more than one injection yields better results from the above literature, but there are of course risks to poking a bunch of holes in your ears (which is how they administrate FX-322, OTO-313, etc.)

The intratympanic injection process itself was not a big deal at all. It took him all of one minute to administer and I laid there for another 10 minutes with the room spinning (normal). And that was it, off I went home.

 

Did they spray a numbing agent in your ear first and is it loud like a tympanometry?

I'm curious, because I'm going to try getting into the OTO-313 Phase 3 trial and a little weary of the whole needle through the eardrum thing.

 

Thanks for all the details on your procedure. And yes, the risks of poking hole(s) in your ears is really what I am concerned about and why I haven't jumped on this.

I also have to assume that you getting it done 2 months in is much better than me looking now to get it 4 years in.

 

There's no real evidence tinnitus "moves" or centralizes into the brain, and there's no analogues system in the entire body or nervous system and it's amazing how stupid the cortex thinks the brainstem is.

 

I'm not sure what to think about that. Another user here posted the below:

"It is well known that when tinnitus becomes chronic, there are chemical and cellular changes along the neural pathways to the central auditory cortex, along with neural changes to the efferent auditory nerves back to the cochlea."

The Role of Central Nervous System Plasticity in Tinnitus

I'm not sure what to believe either way about it. I'd love to believe year 10 tinnitus is the exact same as day 1 tinnitus but I just don't know?

 

He did apply local anesthetic. I barely felt the needle, just a little poke, it wasn't jarring at all. Zero noise.

It should be fine, my otologist said it was very low risk. One of those studies I posted evaluated patients of long term duration if I recall correctly. I haven't been back to those papers since the beginning though.

Right. All of our perceptions arise in the same space of consciousness.

 

The Efficacy of Intratympanic Steroid Injection in Tinnitus Cases Unresponsive to Medical Treatment

The duration of tinnitus in the study group ranged from 12 to 120 months with a mean duration of 35.28±22.67 months. Patients in the control group had tinnitus for a mean of 36.87±21.38 months (range 12–96 months).

...in our patient group, we found a significant reduction in tinnitus at the fourth week and the sixth month. In contrast to our study, in the aforementioned studies, the patients were evaluated at second and fourth weeks. Our follow-up period was longer, and at fourth and sixth months, a significant reduction was detected, which might be due to the late effect of the intratympanic treatment. Another mechanism at work may be the steroid-induced increase in the blood flow to the inner ear. Additionally, the injection protocols and drugs and drug concentrations in the previous studies and in our study were not standard. This could be another reason for the conflicting results.

The results of this study show that intratympanic dexamethasone was effective in the treatment of subjective tinnitus. Intratympanic treatment was demonstrated to improve tinnitus scores in the study group.​

Efficacy of pharmacologic treatment in tinnitus patients without specific or treatable origin: A network meta-analysis of randomised controlled trials

According to the SUCRA, intra-tympanic dexamethasone injection plus oral melatonin was associated with the highest response rate, followed by oral melatonin plus sulodexide and oral melatonin alone (Suppl. B, eTable 4B).
...
Another important finding of the current NMA was the significantly higher response rate of intra-tympanic dexamethasone injection plus oral melatonin than the placebo/waiting-list group. Melatonin has both dopaminergic antagonist effects [50] and anti-oxidant effects [51].
...
​

 

That's great, was it a spray or did they physically swab the ear drum?

 

I honestly don’t remember but I’m pretty sure it wasn’t a spray.

 

Anything's possible, but the study you link only uses neural correlates as their evidence. It was from 2007 when tinnitus research was barely a decade old. Peripheral excitation will stimulate the central correlates, and the brain will adapt on some level but that shouldn't mean it "sticks" forever.

If you wear an arm cast for 2 years, there's no way in hell that that sensation would "stick" when you got the cast removed; no chance. Same if you wore a shirt for 2 years and then took it off. The most complicated thing in the universe is not quite that stupid I believe.

 

After some research, Dexamethasone has the opposite effect as Magnesium. Weird to know it works.

Dexamethasone induces cell death which may be blocked by NMDA receptor antagonists but is insensitive to Mg2+ in cerebellar granule neurons

 

I have the chance to go get Dexamethasone injections tomorrow and my most recent sound damage was about a month ago. Is it worth it? I am dying and willing to try anything for relief from hyperacusis and tinnitus.

 

Could be so many different reasons.

The Dexamethasone is primarily going to hit the hair cells in the basal turn moreso than any nerves firstly.

I did read something similar about chronic stress / cortisol inducing neuron death (only in the hippocampus though if my memory serves). Wouldn't be super surprising Dexamethasone mimics that.

 

@Travis Henry, how did the injections go?

 

They wouldn't give it to me. The doctor didn't believe me that I had sudden hearing loss and was pushing for an audiogram. I didn't lie good enough sadly.

 

That's terrible. I hate having to lie on the audiogram to get injections. It's so stupid because it always helps the tinnitus greatly. But ENTs don't seem to care about tinnitus, they only care about hearing loss.

Try another ENT and lie on the hearing test, specifically the bone conduction part where they test the nerve conduction.

 

I just got my first Intratympanic Dexamethasone to hopefully treat my SSHL and new hyperacusis since oral Prednisone didn't seem to affect the frequency with the biggest hearing loss. The doctors believe my hyperacusis is a result of the SSHL. So kind of a last resort to hopefully improve the remainder of my hearing loss and possibly reverse my hyperacusis.

Day after the shot, I have 2 new tones of tinnitus... so hopefully it's all just part of the recover period.

 

My hearing appeared to improve 2 months post IT injection. Who knows if it’s causal!

 

That's very interesting. Could you expand on this a bit? Did you notice no improvement for a while after the shot and then gradually noticed it coming back over a certain time frame?