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Original Article

The effect of intravenously administered mexiletine on tinnitus-a pilot study

Los efectos de la administración intravenosa del mexiletine sobre el acúfeno – un estudio piloto

, , , , , & show all
Pages 689-696 | Published online: 07 Jul 2009
 

Abstract

The effect of intravenously administered mexiletine on subjective tinnitus and hearing was studied in six patients, who initially responded positively to lidocaine. Distinct mexiletine-induced decreases in tinnitus loudness were demonstrated in three subjects, as reflected by maximum VAS (visual analogue scale) level reduction of 34%, 95%, and 100%, respectively. One subject reported change in tinnitus pitch, another one showed a slight (18% on VAS) tinnitus reduction, and one subject disclosed no effect. Side effects were seen only during one of seven infusions. Mexiletine induced shifts in pure-tone threshold, transient evoked otoacoustic emission, and acoustic reflex threshold, probably reflecting a reversible interference in the function of organ of Corti. The concentration effect relationship remained unclear and no general ‘therapeutic’ level could be identified. This study confirms the effect of mexiletine on the auditory function and its potential as a possible therapeutic agent or a model for further development in tinnitus pharmacotherapy.

Abbreviations
ART=

Acoustic stapedius reflex threshold

IHC=

Inner hair cell

OHC=

Outer hair cell

PTT=

Pure-tone threshold

TEOAE=

Transient evoked otoacoustic emission

VAS=

Visual analogue scale

Abbreviations
ART=

Acoustic stapedius reflex threshold

IHC=

Inner hair cell

OHC=

Outer hair cell

PTT=

Pure-tone threshold

TEOAE=

Transient evoked otoacoustic emission

VAS=

Visual analogue scale

Sumario

Se estudió el efecto sobre la audición y el acúfeno subjetivo de la administración intravenosa del mexiletine, en seis pacientes que respondieron positivamente a la lidocaína. Se demostró una disminución marcada en la intensidad subjetiva del acúfeno inducida por el mexiletine en tres sujetos, reflejado por una reducción en el nivel máximo del VAS (escala visual análoga), de 34, 95 y 100% respectivamente. Un sujeto reportó cambio en el tono del acúfeno, otro mostró una leve reducción en su acúfeno (VAS de 18%), y un sujeto no reportó ningún efecto. Los efectos secundarios se presentaron solo durante una de las siete infusiones. El mexiletine indujo cambios en los umbrales tonales, en las emisiones otoacústicas evocadas por transitorios y en el umbral del reflejo acústico, probablemente mostrando una interferencia reversible en la función del órgano de Corti. El efecto de la concentración no es claro y no se identificó un nivel “terapéutico” general. Este estudio confirma el efecto de mexiletine sobre la función auditiva y su potencial como un posible agente terapéutico o un modelo para el desarrollo ulterior de la farmacoterapia aplicada al acúfeno.

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