kijohns_69c1690d3c57bfec0f0843f3 20260501142025 KIJOHNS Journal editor@kijohns.com KIJOHNS Journal KIJOHNS Journal XXXX-XXXX 2026 1 1 Rajendran Dinesh Kumar Dr.M.G.R. Educational and Research Institute, RajaRajeswari Medical College and Hospital, Bengaluru, India Vithal. D. Udagatti N.R.M ENT Hospital, Near Mahila Samaj, Raichur, India Sara Mathew Dr.M.G.R. Educational and Research Institute, RajaRajeswari Medical College and Hospital, Bengaluru, India Jeshurun Samuel J Dr.M.G.R. Educational and Research Institute, Rajarajeswari Medical College and Hospital, Bengaluru, India Prathamesh Phadke Dr.M.G.R. Educational and Research Institute, Rajarajeswari Medical College and Hospital, Bengaluru, India Pooja C Dr.M.G.R. Educational and Research Institute, Rajarajeswari Medical College and Hospital, Bengaluru, India Background Tinnitus, the perception of sound without an external stimulus, is a common symptom in sensorineural hearing loss (SNHL). It is frequently associated with excitotoxicity caused by excessive glutamate release and reactive oxygen species (ROS), leading to cochlear and neuronal damage. Objective To evaluate the efficacy of caroverine and antioxidant combination therapy in patients with cochlear-origin subjective tinnitus associated with SNHL. Methods This prospective study included 20 patients aged 20–66 years with subjective tinnitus of cochlear/synaptic origin. Exclusion criteria included objective tinnitus, retrocochlear pathology, Meniere’s disease, drug-induced ototoxicity, and middle ear disease. All patients underwent clinical ENT evaluation, audiometry, and were treated with caroverine (20 mg twice daily) and a combination of rebamipide (100 mg), alpha-lipoic acid (100 mg), and acetylcysteine (100 mg), twice daily for 8 weeks. Those with giddiness received cinnarizine (25 mg) and dimenhydrinate (40 mg). Patients were followed up at 15, 30, and 60 days with repeat pure tone audiometry and clinical evaluation. Results Of the 20 patients (10 male, 10 female), complete resolution of tinnitus was observed in 11 cases, partial improvement in 7, and no improvement in 2. Hearing improved in 4 cases and partially in 8; 2 showed no improvement. Giddiness improved completely in 2, partially in 1, and was persistent in 1 case. Thirteen patients were fully satisfied, 3 partially satisfied, and 4 not satisfied with treatment outcomes. Conclusion Caroverine and antioxidant combination therapy significantly improved tinnitus symptoms in SNHL patients by antagonizing NMDA and AMPA glutamate receptors and reducing oxidative stress. This approach may offer a safe and effective management option for cochlear-synaptic tinnitus. Keywords: Tinnitus; Sensorineural Hearing Loss; Glutamic Acid; Antioxidants. 2026 03 23 2026 https://kijohns.com/api/article/69c1690d3c57bfec0f0843f3 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/