INTRATYMPANIC THERAPIES FOR INNER EAR DISORDERS 

Otorinolaringologia 2010 September;60(3):195-205

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Intratympanic management of tinnitus: illusions and hopes

Oliveira C. A., Araújo M. F. S., Sampaio A. L. L.

Department of Otolaryngology, Brasília University Medical School, Brasília, DF, Brasil

Claudius Galeno of Pergamus who was a master in anatomy and physiology advocated delivering medications to the outer and middle ear to treat diseases of the ear (130-200 AD). In our time Schuknecht in 1956 was the first to use streptomycin intratympanic for the treatment of Menière´s disease. However, the incidence of deafness was very high. Two decades later Beck and Schmidt used gentamycin for vestibular ablation in Menière´s disease patients and by carefully titrating the dosis they were able to low the incidence of hearing loss. This and others reported successes led investigators to use several intratympanic drug injections to treat tinnitus. Lidocaine, had been shown to suppress tinnitus when injected systemically and was also tried in the intratympanic route. Aminoglicosides and steroids, were also tried for treatment of tinnitus, sudden sensori-neural hearing loss and auto-immune deafness. Neuroactive drugs also have been used to treat tinnitus using the intratympanic route. While there have been many reports optimistic about the intratympanic route for drug delivery in the treatment of tinnitus up to now this method of treatment is still controversial and no specific drug has been shown to be consistently effective when injected intratympanically. This report will present the evidences reported in the literature and try to sort out what is illusion what is supported by facts and what hopes we can have for the future in this field.