[Therapy of severe tinnitus. A report of experiences]

From August 1985 until March 1987, 79 patients with tinnitus were examined and treated in our clinic. In 26% of our patients tinnitus was probably noise-induced. In audiometry, high-frequency hearing loss combined with high-pitched tinnitus like ringing and hissing was most frequently found. Cochlear disturbances involving the total frequency range were often detected following acute hearing loss, in otosclerosis and in Ménière's disease, causing predominantly low-pitched broadband tinnitus. A high-dose intravenous lidocaine infusion resulted in a reduction of tinnitus in 25 of 44 patients tested (57%), without any relation to the type of sound, to the aetiology or the type of hearing loss. Iontophoresis with local anaesthetics did reduce tinnitus temporarily for several hours in 44% of the patients, but only 30% of these responders wished to have more than 10 sessions. If lidocaine infusion had no effect, iontophoresis did not produce any effect either. Patients suffering from severe unbearable tinnitus were selected for tocainide hydrochloride therapy and 5 were treated successfully. Nevertheless, we consider it indispensable to take blood tests periodically to provide against allergic agranulocytosis.