Intratympanic dexamethasone injection for tinnitus treatment: Can success be predicted?

Objectives: This study aims to conduct a statistical analysis of clinical and audiological data based on treatment outcomes to examine the factors influencing treatment success of intratympanic dexamethasone injection (ITDI) in patients with tinnitus. Patients and Methods: This retrospective study included 25 tinnitus patients (16 males, 9 females; mean age: 52.8±13.9 years; range, 27 to 72 years) who underwent ITDI treatment at our hospital between September 1, 2023, and September 1, 2024. Patients who completed four doses of treatment and were followed up for six months, with available pre- and posttreatment Tinnitus Handicap Inventory (THI) scores and audiometric evaluations, were included in the analysis. Results: The rates of vertigo, comorbid conditions, and smoking history were 44%, 8%, and 7%, respectively. The median duration from symptom onset to treatment initiation was 20.4 (range, 1 to 120) months. Treatment success was significantly lower in patients with a history of vertigo compared to those without vertigo (27.3% vs. 78.6%, p=0.01). There were no significant differences in success rates based on age, sex, laterality, presence of comorbidities, smoking status, or tinnitus duration (<3 months vs. >3 months; p>0.05 for all). Audiometric analysis showed no significant changes in hearing thresholds at 250-8000 Hz after treatment. However, patients who exhibited greater hearing loss at 8000 Hz in pretreatment audiometry had lower success rates (p=0.051). Conclusion: The presence of vertigo and severe high-frequency hearing loss may negatively influence the success of ITDI treatment in tinnitus patients.