Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Botox® Provides Some Relief from Tinnitus Irritation

20.09.2004


A preliminary study indicates that BOTOX® injections may ease the irritation of tinnitus, otherwise know as ringing in the ears, for some patients. Researchers say more study is needed, but initial results are promising.



Tinnitus, or the presence of noises (ringing, whistling, hissing, roaring, booming) in the ears, is a common complaint affecting an estimated 10-20 percent of the general population. Chronic, persistent tinnitus can affect one’s ability to work, engage in social activities, and sleep. For some, the problem is much more harmful, affecting their mood with resulting mild to severe depression. Five percent of the general population are affected by tinnitus to a severity that it causes them to seek help.

The clinical causes of tinnitus have been explored in an effort to explain why this disorder affects individuals so differently, with some having only mild recognition of the symptom and others having true annoyance and more serious interference with their quality of life. Many experts now believe that tinnitus is affected by the autonomic nervous system.


BOTOXâ is most commonly known as a remedy to diminish wrinkle and frown lines and for more serious medical conditions including strabismus, spasmodic altered voice production, failure of the voice muscles to relax, and cervical dystonia. More recently, BOTOXâ has shown significant benefit through nonparalytic effects for problems including neuropathic pain and migraines. Specifically, in management of migraines, BOTOXâ is suspected to block not only acetylcholine, but inhibit release of other neurotransmitters and neuropeptides important in the autonomic pathway.

With BOTOXâ having proven benefit in disease processes via blockage of autonomic pathways, and a significant aspect of tinnitus believed to be effected via the autonomic pathway, researchers set out to examine whether BOTOX® could possibly impact the perception of tinnitus. The authors of “Evaluation of Botox® in Treatment of Tinnitus,” are Katrina R. Stidham MD with the California Ear Institute at San Ramon, Perry Solomon MD, Director-Bridges Medical Clinic-for BOTOX rx for Migraines and Hyperhydrosis, and Joseph B. Roberson MD, California Ear Institute and Let Them Hear Foundation, all from California. Their findings are being presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting & OTO EXPO, being held September 19-22, 2004, at the Jacob K. Javits Convention Center, New York City, NY.

Methodology: Adult patients, 18 years or older were identified for a variety of problems including primary tinnitus, hearing loss, and Meniere’s disease. Those included in the study had unilateral or bilateral non-pulsatile tinnitus with audiometrically normal hearing; sensorineural, conductive, or mixed hearing loss for more than two months; no evidence of middle ear disease, chronic middle ear infection, or mastoid infection; asymmetric hearing loss with dizziness; and for females, concurrent use of a reliable method of contraception. Exclusion criteria included known allergy to botulinum toxin type A, any medical condition that may put the subject at increased risk with exposure to BOTOX â, use of aminoglycoside antibiotics, curare-like agents, or other agents that might interfere with neuromuscular function, throbbing tinnitus, upcoming neurotologic or otologic surgery for chronic ear disease, vestibular schwannoma, meningioma or skull base tumors, significant psychiatric history or associated diagnosis of major depression, younger than age 18 years, pregnancy, and concurrent tinnitus treatment.

BOTOX® was reconstituted in preservative free saline with 2.5 cc of saline per 100 unit vial. The side of injection was chosen based on the patient’s subjective source of tinnitus in cases of unilateral tinnitus. For patients with bilateral tinnitus, the patient was asked to identify the louder side and if no louder side was notable, one side was arbitrarily selected for injection. When receiving BOTOX®, the total dose was equally divided and injected into three sites around the ear; one cm above superior aspect of auricle, one cm behind auricle at the 2 o’clock position, and one cm behind auricle at the 5 o’clock position. When receiving placebo, equal amounts of saline were injected at each of these sites to match the BOTOX® total volume.

Patients were placed into one of two treatment arms. Patients in treatment arm #1 received BOTOX® at the first injection, and placebo at the second injection four months later. Patients in treatment arm two received placebo at the first injection and BOTOX® at the second injection four months later. The lower dose of 20 units was injected in the first blinded treatment group (total 5 patients) to verify safety. All of the subsequent BOTOX® injections were 50 units. All patients were blinded to the injections until at least four months after the second injection.

Due to the difficult nature to record and follow subjective tinnitus, several methods were used in an attempt to follow tinnitus for individual patients. Hearing was also closely followed. Subjective methods included questionnaires, Tinnitus Handicap Inventories (THIs), and tinnitus and hearing rating scales. All patients were asked to fill out tinnitus questionnaires prior to receiving the first injection. Questionnaires recorded data regarding length of tinnitus, side affected, and subjective description of tinnitus.

Results: Twenty-six patients completed both injections and all follow-up and were included in data analysis. Following BOTOX® treatment, subjective tinnitus changes included seven patients improved, three worsened, and sixteen unchanged. Following placebo treatment, two patients were improved, seven worsened, and seventeen unchanged. Comparison of the treatment and placebo groups was statistically significant (p<.005) when including better, worse, and same effects. Results were not statistically significant evaluating the better versus worse and unchanged effects combined. A significant decrease in THI scores between pre-treatment and four month post BOTOX injection (p=.0422) was recorded. None of the other comparisons of pre-treatment – one month, or pretreatment – four months were significantly different.

Conclusion: In this study, BOTOX® was used to treat a small number of patients with tinnitus originating from a variety of causes. While the results suggest a positive effect of BOTOX® on irritation from tinnitus, the authors recommend a larger study to document repeatable results prior to drawing definitive conclusions regarding the potential benefits of BOTOX® in treatment of tinnitus.

| newswise
Further information:
http://www.entnet.org

More articles from Health and Medicine:

nachricht Correct connections are crucial
26.06.2017 | Charité - Universitätsmedizin Berlin

nachricht One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Study shines light on brain cells that coordinate movement

26.06.2017 | Life Sciences

Smooth propagation of spin waves using gold

26.06.2017 | Physics and Astronomy

Switchable DNA mini-machines store information

26.06.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>