{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T16:06:35Z","timestamp":1771430795086,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF\u2010RS\u20102024\u201000340841"],"award-info":[{"award-number":["NRF\u2010RS\u20102024\u201000340841"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF\u20102021R1F1A1049965"],"award-info":[{"award-number":["NRF\u20102021R1F1A1049965"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Investigating the efficacy and safety of intratympanic Botulinum toxin (IT\u2010BTX) injection as a novel treatment for middle ear myoclonic tinnitus (MEMT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records and tinnitus questionnaires of the patients with MEMT who underwent IT\u2010BTX were retrospectively reviewed. The efficacy of IT\u2010BTX on MEMT as well as its safety were evaluated by audiology tests and tinnitus questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 57 patients who completed the questionnaires at pre\u2010 and post\u2010IT\u2010BTX were enrolled. Tinnitus handicap inventory (THI) scores decreased significantly from pre\u2010IT\u2010BTX (44.31\u2009\u00b1\u200926.8) to 31.42\u2009\u00b1\u200923.6 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), 32.92\u2009\u00b1\u200924.9 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), and 25.71\u2009\u00b1\u200922.9 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) at 1\u2010, 3\u2010, and 6\u2010months post\u2010IT\u2010BTX, respectively. Additionally, visual analog scales (VAS) of loudness (LD), awareness (AW), annoyance (AN), and effect on life (EF) significantly decreased post\u2010IT\u2010BTX (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05): LD from 4.19\u2009\u00b1\u20092.4 to 2.47\u2009\u00b1\u20092.0, 2.89\u2009\u00b1\u20092.2, and 2.38\u2009\u00b1\u20091.9 at 1\u2010, 3\u2010, and 6\u2010months; AW from 41.75\u2009\u00b1\u200929.5 to 24.38\u2009\u00b1\u200923.3, 26.94\u2009\u00b1\u200923.3, and 22.10\u2009\u00b1\u200921.7; AN from 5.00\u2009\u00b1\u20092.8 to 2.82\u2009\u00b1\u20092.1, 3.47\u2009\u00b1\u20092.4, and 2.78\u2009\u00b1\u20092.2; EF from 4.82\u2009\u00b1\u20092.8 to 2.89\u2009\u00b1\u20092.2, 3.28\u2009\u00b1\u20092.4, and 2.73\u2009\u00b1\u20092.2 at 1\u2010, 3\u2010, and 6\u2010months post\u2010IT\u2010BTX. Notably, 40.3% of the IT\u2010BTX patients experienced a complete cure of their MEMT symptoms, while 50.8% demonstrated partial resolution after IT\u2010BTX. There were no side effects or complications after IT\u2010BTX during their follow\u2010up period. Comparing delta values between the single injection group and multiple injection group revealed significant differences in VAS LD at the post\u20101\u2010month time point and between the 1\u2010month and 6\u2010month intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IT\u2010BTX is an effective, safe treatment for MEMT, significantly improving symptoms without complications, and offers a promising alternative before middle ear tendon resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 4<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32447","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T10:13:25Z","timestamp":1753438405000},"page":"403-410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Intratympanic Botulinum Toxin Injection on Middle Ear Myoclonic Tinnitus"],"prefix":"10.1002","volume":"136","author":[{"given":"Ji Hyung","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dowoon","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranco C.","family":"Velasco","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Rizal Medical Center  Pasig City Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Jun","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-1232","authenticated-orcid":false,"given":"Jae Sang","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Mee","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Gangneung Asan Hospital, College of Medicine University of Ulsan  Gangneung Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8443-8581","authenticated-orcid":false,"given":"Jae Hyun","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6419-1000","authenticated-orcid":false,"given":"So Young","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7614-9413","authenticated-orcid":false,"given":"Shi Nae","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1258\/0022215001905120"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/175268"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811434504"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000487260"},{"key":"e_1_2_8_6_1","first-page":"67","article-title":"Bilateral 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