Abstract

Background: Tinnitus results from the perception of abnormal activity, defined as activity which cannot be induced by any combination of external sounds. Various modalities have been tried with varying results. The aim of our study was to compare efficacy of oral 5-MTHF, Vitamin B12 and Gingko Biloba with oral Caroverine and ginkgo biloba in treatment of Sensorineural tinnitus.
Material and Methods: This prospective study included 60 tinnitus patients both male and female between 18-60 years of age having serum vitamin B12 level <230pg/ml and serum folic acid level< 3ng/ml. Patients with a history of test drug allergy, those on vitamin B12 and folic acid supplementation, pregnancy, psychiatric disorders and those with middle ear/external ear pathology were excluded from the study. After otorhinolaryngological examination, patients were divided into two groups, Group A(32 patients) received a combination of oral 5-methyl tetra hydro folate(5-MTHF) 800 mcg/day as a single daily dose, oral vitamin B12 (methylcobalamin) 1500 mcg/day as a single daily dose and oral Gingko Biloba 120 mg/day in two divided doses and Group B(28 patients) received oral Caroverine 40 mg/day in two divided doses and oral Gingko Biloba120 mg/day in two divided doses. Patients were followed up and evaluated on 0, 1, 2 and 3 month over a period of 3 months for S.Vitamin B12 level, S.Folic acid level and improvement of clinical symptoms in terms of tinnitus grading and tinnitus matching.
Results: The mean tinnitus matching (in dB) at Pre-Treatment and Post-Treatment (1 month, 2 month and 3 month) was 42.50±11.77, 37.50±12.25, 34.69±11.57 and 32.97±12.30 in group A and 47.86±12.28, 40.89±13.48, 40.36±12.69 and 40.18±12.73 in group B, respectively. The mean tinnitus matching (in dB) was significantly lower in group A as compared to group B at 3^rd month. Moreover, the mean tinnitus matching (in dB) was significantly decreased in group A from Pre-Treatment to 3 month.
Conclusion: With 5-MTHF, vitamin B12 and Gingko Biloba, mean serum folate level and mean serum vitamin B12 level shows a significant improvement (p<0.05) after the end of treatment compared to caroverine and Gingko Biloba; similar improvement was also seen for mean tinnitus matching and mean tinnitus grading. Thus, combination of oral 5-MTHF, Vitamin B12 and Gingko Biloba is thus found to be more effective treatment modality for Sensorineural tinnitus on long term basis