Safety of Intratympanic Steroids (Betamethasone)?

[Stacken77]

Hello everyone,

The tinnitus in my left ear has worsened significantly a few times over the year from seemingly minor traumas. Its resiliency to sound is completely unlike my right ear. I have reactive tinnitus and spike to most sound; I believe it's a centralized issue due to my significant loudness hyperacusis, but the unilateral progression of my left ear doesn't seem to line up with this model - I believe there is some kind of damage going on here.

I recently brought up intratympanic steroids with my ENT as a means for ruling out inflammation and other causes for this progression and she were, to my surprise, not against trying it. They use Betamethasone, and not the commonly known Dexamethasone.

As with any treatment, I understand that there is a risk involved. Worst case would be to worsen my tinnitus further due to the injection. What is your experience with intratympanic steroids; has it caused any significant worsening in tinnitus? Do you think the risk is low enough to give it a try, and do you think it's reasonable?

Wish you well,
Stacken

 

[FlatDarkEarth]

Hey Stacken.

There is a clinic near me (Shea Clinic) that seems pretty well known for using this procedure, although I believe they use Dexamethasone. I know this doesn't answer your question but may give you some perspective.

One report of success:

Intratympanic Dexamethasone Injections Greatly Helped My Tinnitus

 

[Rockman]

Hello everyone,

The tinnitus in my left ear has worsened significantly a few times over the year from seemingly minor traumas. Its resiliency to sound is completely unlike my right ear. I have reactive tinnitus and spike to most sound; I believe it's a centralized issue due to my significant loudness hyperacusis, but the unilateral progression of my left ear doesn't seem to line up with this model - I believe there is some kind of damage going on here.

I recently brought up intratympanic steroids with my ENT as a means for ruling out inflammation and other causes for this progression and she were, to my surprise, not against trying it. They use Betamethasone, and not the commonly known Dexamethasone.

As with any treatment, I understand that there is a risk involved. Worst case would be to worsen my tinnitus further due to the injection. What is your experience with intratympanic steroids; has it caused any significant worsening in tinnitus? Do you think the risk is low enough to give it a try, and do you think it's reasonable?

Wish you well,
Stacken

I'm in the same boat as you. I've had hyperacusis now for a year with very little improvement. Just like you, my one ear is so sensitive. From anything, like it never heals since anything can aggravate it. I do go a couple days sometimes with no discomfort and all it takes is a beep on the TV to hurt it.

 

[Uklawyer]

@Stacken77, on here, Dexamethasone seems to be the popular choice. It also appears to have helped a few people on here. Check the Success story thread of @Renka. She had a Silverstein Microwick inserted and had a number of treatments with Dexamethasone.

Hopefully it can provide you with a good measure of relief.

Best of luck.

 

[Rockman]

Check the Success story thread of @Renka. She had a Silverstein Microwick inserted and had a number of treatments with Dexamethasone.

@Uklawyer, after reading her story, I dunno haha. She seemed to have a lot of side effects. Unless she had other underlying conditions.

 

[Uklawyer]

@Rockman, you are right, she did have some side effects. I don't think she had any permanent effects though. And the tinnitus resolved completely didn't it?

There is also another recent thread on Dexamethasone injections somewhere.

 

[Rockman]

There is also another recent thread on Dexamethasone injections somewhere.

Yes there is another success story that didn't have any side effects.

 

[David S]

@Stacken77, sorry to hear about your worsening. I am in a similar situation.

Have you been thinking about this anymore? Does your ENT think that it can help with inflammation or any other mechanisms?

 

[Stacken77]

@Stacken77, sorry to hear about your worsening. I am in a similar situation.

Have you been thinking about this anymore? Does your ENT think that it can help with inflammation or any other mechanisms?

I will see her next Monday. If she's willing to do it, I will roll the dice and try it. Even if it yields temporary relief, it could explain more about the situations. She were not convinced about "inflammation", but more about if I might have Meniere's (which I lack symptoms for). I will report back whatever happens next week.

Sorry to hear about your situation. Really hoping we could have some relief.

Wish you well.

 

[David S]

Keeping my fingers crossed for you!

I think we both suffer from some damage in the high frequency area of the cochlea. It should be the easiest for the compound to reach.

Imagine that a few hundred cells in an area of a few cubic mm can create so much suffering.

 

[David S]

@Stacken77, how did it go today? Are you sill considering intratympanic steroids?

 

[Stacken77]

Hey David,

Are you sill considering intratympanic steroids?

My ENT strongly advised against going through with it, but were more open towards a course of oral steroids. We'll discuss things further next week. She also ordered another audiogram.

 

[David S]

@Stacken77, that is probably a wise decision.

Did you ever do a high frequency hearing test? 8-16 kHz?

How do you perceive your tinnitus? Sometimes as tickling or small sensations? Morse code?

 

[Stacken77]

Did you ever do a high frequency hearing test? 8-16 kHz

It is not given in my Region in Sweden, and I haven't looked into private audiologists.

How do you perceive your tinnitus? Sometimes as tickling or small sensations? Morse code?

Bilateral, but very much localized to the ears, position-wise. Multiple tones in varying volumes, but the most distressing ones are a ring with a very harsh signature, almost like an angle grinder running in a sheet of steel.

~Stacken

 

[David S]

Bilateral, but very much localized to the ears, position-wise. Multiple tones in varying volumes, but the most distressing ones are a ring with a very harsh signature, almost like an angle grinder running in a sheet of steel.

And hard to mask because it is reactive? High pitched? Your hearing is fine up to 8 kHz?

 

[Greg Sacramento]

The trauma hospital where I worked had 6 ENTs and 4 outpatient ENTs that provided corticosteroid methylprednisolone injections. None of the hospital associated clinics provided injections.

Injections were given for Meniere's disease and idiopathic acute sudden sensorineural hearing loss (ISSNHL). Injections were given for those with acute tinnitus, but not for those with chronic tinnitus. For those with Meniere's disease, patient needed to experience vertigo.

Success and safety came down to the expertise of the ENT.

One outpatient ENT was outstanding and never had a patient safety issue. He also had a 70% rate with lowering tinnitus and patients had outstanding results. At that time, the national average for a reduction was 40%.

The other ENTs within the hospital system had a 40% average of lowering tinnitus. These ENTs had safety issues.

To add, the high success rate of 70% for one ENT may be due to him always making a secondary perforation (borehole) into the tympanic membrane - maybe to relieve pressure?

He was also a very skilled reconstructive trauma ear surgeon. A real nice and understanding doctor, now retired.