{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:02:38Z","timestamp":1789704158427,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T00:00:00Z","timestamp":1675036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T00:00:00Z","timestamp":1675036800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Middle ear myoclonic tinnitus (MEMT) is a disease caused by myoclonus or abnormal contractive movement of middle ear muscles (MEMs). This translational study was conducted to propose intratympanic botulinum toxin (IT\u2010BTX) injection as a new therapeutic modality to treat MEMT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Animal experiment and nonrandomized controlled clinical trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Laboratory and medical center of an academic tertiary medical institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For the animal study, male Sprague\u2010Dawley rats were divided into 4 subgroups according to the sacrificing day after IT\u2010BTX injection. After initial hearing tests, randomly assigned experimental ears were intratympanically injected with 1\u2009unit\/100\u2009\u03bcL of BTX\u2010A, whereas control ears were injected with normal saline. Changes in the hearing thresholds, morphometry of the cochleae, electron microscopy study, and immunofluorescence analysis of MEMs were evaluated. For the human study, 10 intractable MEMT patients were enrolled. The hearing thresholds and the degree of tinnitus distress were observed for changes after IT\u2010BTX injection. All patients were followed up for 3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>As for the animal study, there were no significant changes in hearing thresholds and cochlear morphologies in all 4 subgroups of the rats. Significant MEM degenerations and immuno\u2010detection of cleaved synaptosome\u2010associated protein of 25\u2009kDa (cSNAP\u201025) indicated the efficacy of IT\u2010BTX. MEMT patients enrolled for the pilot clinical trial showed statistically significant improvement in tinnitus after IT\u2010BTX injection. No major complications were noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The new therapeutic modality of IT\u2010BTX injection for the treatment of MEMT seems highly promising with an excellent result.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.256","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T09:44:54Z","timestamp":1675071894000},"page":"348-357","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Intratympanic Botulinum Toxin Injection as a New Therapeutic Modality for Middle Ear Myoclonic Tinnitus"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8589-4119","authenticated-orcid":false,"given":"Jung M.","family":"Park","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery, Gangneung Asan Hospital College of Medicine University of Ulsan Gangneung Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Seoul St\u00a0Mary's Hospital, College of Medicine The Catholic University of Korea Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae S.","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Seoul St\u00a0Mary's Hospital, College of Medicine The Catholic University of Korea Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Y.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Yeouido St\u00a0Mary's Hospital, College of Medicine The Catholic University of Korea Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7614-9413","authenticated-orcid":false,"given":"Shi N.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Seoul St\u00a0Mary's Hospital, College of Medicine The Catholic University of Korea Seoul Republic of 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