OTOLOGY The evaluation of ozone and betahistine in the treatment of tinnitus Onur So ¨nmez • I ˙ smail Ku ¨lahlı • Alperen Vural • Mehmet I ˙ lhan S ¸ ahin • Mesut Aydın Received: 10 March 2012 / Accepted: 11 October 2012 / Published online: 26 October 2012 Ó Springer-Verlag Berlin Heidelberg 2012 Abstract The aim of the study is to evaluate the effec- tiveness of ozone and betahistine treatments in the treat- ment of tinnitus. Sixty-eight patients were enrolled in this randomized, prospective controlled study. The ozone group consisted of 27, betahistine group consisted of 26 and control group consisted of 15 patients. The patients in ozone group received 10 sessions of ozone treatment via major autohemotherapy. Betahistine group received 48 mg/day betahistine tablets per oral for 3 months duration. The control group was followed up without any treatment given. The evaluation of tinnitus was made by tinnitus loudness and tinnitus handicap inventory (THI). The changes in findings from baseline to 3rd and 6th months were assessed, and the group results were compared. Comparison of the initial mean tinnitus loudness and 3 and 6 months after treatment in each of the three groups did not reveal a sig- nificant difference. The comparison between the groups in terms of the improvement of tinnitus loudness was not significant (p = 0.821). Comparison of the initial mean THI and 3 and 6 months after treatment revealed a significant difference in ozone and betahistine groups but not in the control group. When the delta (D) THI (the change of mean THI between the initial and 6th month) was compared between the groups, there was no significant difference. This randomized controlled study investigating the effects of ozone in tinnitus tries to shed light to a new method of treatment in tinnitus. The findings of the study does not provide enough evidence to support ozone and betahistine as a treatment for tinnitus and further research on the subject is necessary. Keywords Tinnitus Á Ozone Á Betahistine Introduction Tinnitus is defined as a perception of a sound that cannot be attributed to an external source [1] and, is a common complaint that affects an estimated 10 to 20 % of the general population [2, 3]. While for a majority of patients with tinnitus, their symptom does not interfere with their daily lives, for the rest it is debilitating and interferes with work, socialization, and sleep [4]. There are multiple causes of tinnitus from inner ear disorders to systemic diseases. Although several theories have been proposed to explain the mechanism of tinnitus, the exact pathophysiological processes remain unknown [4]. Disturbance of cochlear microcirculation is one of the most frequently discussed reasons. In experimental condi- tions, even limited impairment of cochlear blood flow leads to an immediate dysfunction of the outer hair cells (OHC’s) of the cochlea [5, 6]. The role of cochlea in tinnitus is O. So ¨nmez Nevsehir Dr. I. Sevki Atasagun State Hospital, Nevsehir, Turkey e-mail: kbbonursonmez@yahoo.com I ˙ . Ku ¨lahlı Á A. Vural (&) Á M. I ˙ .S ¸ ahin Á M. Aydın Department of Otorhinolaryngology, Erciyes University Faculty of Medicine, Kayseri, Turkey e-mail: alperenvural@yahoo.com I ˙ . Ku ¨lahlı e-mail: ikulahli@erciyes.edu.tr M. I ˙ .S ¸ ahin e-mail: misahin@yahoo.com M. Aydın e-mail: monopril571@hotmail.com A. Vural Erciyes Universitesi Kulak Burun Bogaz Klinigi, 38039 Kayseri, Turkey 123 Eur Arch Otorhinolaryngol (2013) 270:1999–2006 DOI 10.1007/s00405-012-2228-8