Effectiveness of bisphosphonate for alleviating tinnitus associated with otosclerosis: a prospective case–control study

To investigate the short-term efficacy of third-generation bisphosphonate in the management of tinnitus associated with otosclerosis.

A prospective case–control study included 100 patients with otosclerosis-associated bothersome tinnitus. Patients were assigned to two groups: group A (control): 25 patients who planned to receive only complementary supplements, oral vitamin D plus calcium, and group B (case): 75 patients who planned to receive oral bisphosphonate plus routine vitamin D and calcium supplements. Group B was subdivided into B₁: 25 patients without any previous intervention, B₂: 25 patients with persistent tinnitus for more than 6 months after a previous uncomplicated stapedotomy in the same ear, and B₃: 25 patients with persistent tinnitus for more than 6 months after hearing aid fitting. The outcome was tinnitus assessment both subjectively (tinnitus intensity, frequency, and questionnaire) and objectively (tinnitus intensity and frequency).

The female-to-male ratio was 1.6:1 with ages ranging from 40 to 61 years. The baseline revealed no statistically significant differences between the groups. After 6 months, there were statistically significant differences, both objectively and subjectively. The tinnitus questionnaire median (IQR) for group B was 16 (30), whereas control group A had 52 (24). The tinnitus severity median (IQR) for group B was 20 (30), compared to group A’s 52 (42). After 6 months, 40% of the cases in group B demonstrated complete improvement, compared to 0% in control group A.

We demonstrated significant tinnitus improvement in cases treated with bisphosphonate compared to the control group.