[The treatment of tinnitus]

Tinnitus does not present a uniform clinical picture but may represent a symptom of local or systemic disease. If it persists after treatment of the underlying disease or condition, symptomatic treatment should be instituted. Selection criteria for the therapeutic strategy are provided by a classification on the basis of the following points: 1. can be masked by a sound, 2. response to parenteral lidocaine. For clinical purposes, these forms of tinnitus can be considered cochlear or neural, respectively. The cochlear form is best treated by physical means (tinnitus masking), peripheral-neural tinnitus by antiarrhythmic drugs. Successful management requires a particular doctor/patient relationship in which the patient needs above-average time and attention, which the physician cannot delegate to others.