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Randomised Controlled Clinical Study of Injection Caroverine and Ginkgo Biloba Extract in Cochlear Synaptic Tinnitus


Tinnitus, also known as phantom auditory perception, is an annoying symptom and 13–17% of population reports bothersome tinnitus. Cochlear synaptic tinnitus is the most common type. Many treatments have been tried but none is yet considered to be well established. To evaluate effect of Inj.Caroverine and Ginkgo Biloba extract in cochlear synaptic tinnitus in terms of improving tinnitus grading, tinnitus matching and quality of life of patient. It is Randomised controlled study, conducted in department of ENT, on 86 patients, who met inclusion criteria, divided into 4 groups. Gr1—Inj Caroverin, Gr2—Inj Placebo, Gr3—Ginkgo Biloba extract, Gr4—Placebo as extract. A single dose infusion of caroverine immediately improves tinnitus grading and matching and provides immediate relief in reducing severity of tinnitus in 54.54% cases but improvement was not sustained in caroverine group at 3 month and 6 month follow-up after infusion. Ginkgo biloba also is effective in improving tinnitus grading and matching in 31.8% cases and improvement was sustained in ginkgo biloba group even after 3 month of cessation of treatment i.e. at 6 month follow-up. It is suggested that Inj.Caroverine as intravenous infusion should be given in severe cases of tinnitus to reduce its severity immediately and then patient should be put on Tab.Ginkgo biloba for a period of 3 months to provide sustained and long lasting relief. Thus combination therapy of Inj.Caroverin and Tab.Ginkgo Biloba, appropriately tailored to the need of patient will provide better results in greater majority of patients.

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  1. Jastrboff PJ (1990) Phantom auditory perception (tinnitus): mechanism of generation and perception. Neurosci Res 8:221–254

    Article  Google Scholar 

  2. Fowler EP (1965) Subjective head noises (tinnitus aurium): genesis and differential, diagnostic significance. A few facts and several speculations. Laryngoscope 75:1610–1618

    CAS  Article  Google Scholar 

  3. Cooper JC Jr (1994) Tinnitus, subjective hearing loss and well being. Health and Nutrition Examination Survey of 1971–75: part II. J Am Acad Audiol 5:37–43

    PubMed  Google Scholar 

  4. Coles RRA (1984) Epidemiology of tinnitus: (1) Prevalence and (2) Demographic and clinical features. J Laryngol Otol Suppl 9(7–15):195–202

    Article  Google Scholar 

  5. Tyler RS, Kesely D (1990) Advantages and disadvantages reported by some of the better cochlear- implant patients. Am J Otol 11:282–289

    CAS  PubMed  Google Scholar 

  6. Shulman A, Goldstein B (1996) A final common pathway for tinnitus. Implications for treatment. Int Tinnitus J 2:137–142

    CAS  PubMed  Google Scholar 

  7. Jhonson RM, Brummett R, Scluening A (1993) Use of Alprazolam for relive of tinnitus. Double blind study. Arch Otolaryngol Head Neck Surg 119:842–845

    Article  Google Scholar 

  8. Murai K, Tyler RS, Harker LA, Sttoufer JL (1992) Review of pharmacological treatment of tinnitus. Am J Otol 13:454–464

    CAS  PubMed  Google Scholar 

  9. Dobie RA (1999) A review of randomized clinical trial in tinnitus. Laryngoscope 109:1202–1211

    CAS  Article  Google Scholar 

  10. Shea JJ, Harell M (1978) Management of tinnitus aurium with lidocaine and carbamazepine. Laryngoscope 88:1477–1484

    CAS  Article  Google Scholar 

  11. Melding PS, Goodey RJ (1973) The treatment of tinnitus with oral anticonvulsants. J Laryngol Otol 93:111–122

    Article  Google Scholar 

  12. Briner W, House J, O’Leary M (1993) Synthetic prostaglandin E1 misoprostal as a treatment of tinnitus. Arch Otolaryngol Head Neck Surg 119:652–654

    CAS  Article  Google Scholar 

  13. Yilmaz I, Akkuzu B, Cakmak O, Ozuloglu LN (2004) Misoprostal in treatment of tinnitus: a double blind study. Otolaryngol Head Neck Surg 130:604–610

    Article  Google Scholar 

  14. Barany B (1935) Die Beeinflussung des ohrensausens durch intravenous injizierte Lokalanaesthetica. Acta Otolaryngol 23:201–207

    Article  Google Scholar 

  15. Ehrenberg K, Denk DM, Heinz H, Franz P (1997) Carovarine in tinnitus treatment. A placebo controlled blind study. Acta Otolaryngol 117:825–830

    Article  Google Scholar 

  16. Meyer B (1986) Etude multicentrique randomise a double insuface au placebo du traitment des acouphenes par I’ extrait Ginkgo biloba. La Presse Med 15(1562):1564

    Google Scholar 

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Correspondence to Anil Kumar Jain.

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Nishad, R.K., Jain, A.K., Singh, M. et al. Randomised Controlled Clinical Study of Injection Caroverine and Ginkgo Biloba Extract in Cochlear Synaptic Tinnitus. Indian J Otolaryngol Head Neck Surg 71, 1523–1528 (2019).

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  • Tinnitus
  • Injection caroverine
  • Ginkgo biloba extract
  • Cochlear
  • Cochlear synaptic tinnitus