New Treatment Shows Promise for Middle Ear Myoclonic Tinnitus
Intratympanic botulinum toxin injections (IT-BTX) have demonstrated significant efficacy and safety in treating Middle Ear Myoclonic Tinnitus (MEMT), offering a potential new therapeutic avenue for patients suffering from this condition.
Background
Middle Ear Myoclonic Tinnitus (MEMT) is a condition characterized by involuntary contractions of the muscles in the middle ear, which can led to bothersome tinnitus. While surgical interventions like middle ear tendon resection exist, the search for less invasive and equally effective treatments continues.
Methods:
A retrospective review of medical records and tinnitus questionnaires was conducted for patients diagnosed with MEMT who received IT-BTX. The study assessed the effectiveness and safety of IT-BTX through audiology tests and standardized tinnitus questionnaires.
Results:
The study included 57 patients who completed pre- and post-IT-BTX questionnaires. Tinnitus Handicap Inventory (THI) scores showed a marked improvement, decreasing significantly from a pre-treatment average of 44.31 ± 26.8 to 31.42 ± 23.6 at 1 month (p < 0.001), 32.92 ± 24.9 at 3 months (p = 0.004),and 25.71 ± 22.9 at 6 months (p < 0.001) post-injection. Furthermore, visual analog scale (VAS) ratings for loudness (LD), awareness (AW), annoyance (AN), and effect on life (EF) all experienced significant reductions (p < 0.05). Specifically, LD decreased from 4.19 ± 2.4 to 2.47 ± 2.0 (1 month), 2.89 ± 2.2 (3 months),and 2.38 ± 1.9 (6 months). AW dropped from 41.75 ± 29.5 to 24.38 ± 23.3 (1 month), 26.94 ± 23.3 (3 months), and 22.10 ± 21.7 (6 months). AN reduced from 5.00 ± 2.8 to 2.82 ± 2.1 (1 month), 3.47 ± 2.4 (3 months), and 2.78 ± 2.2 (6 months). EF decreased from 4.82 ± 2.8 to 2.89 ± 2.2 (1 month), 3.28 ± 2.4 (3 months), and 2.73 ± 2.2 (6 months). Notably, 40.3% of patients reported a complete resolution of MEMT symptoms, and 50.8% experienced partial improvement following IT-BTX. No adverse side effects or complications were reported during the follow-up period. A comparison of changes between patients receiving a single injection versus multiple injections revealed significant differences in VAS LD at the 1-month post-treatment mark and between the 1-month and 6-month intervals.
Conclusion:
Intratympanic botulinum toxin injections (IT-BTX) represent a safe and effective treatment option for Middle Ear Myoclonic Tinnitus (MEMT), leading to substantial symptom improvement without adverse events. This approach offers a promising choice for patients prior to considering middle ear tendon resection surgery.
keywords:
botulinum toxin; intratympanic injection; middle ear myoclonic tinnitus.
