Therapie schwerer Ohrgeräusche

The effect of lidocaine iontophoresis for the treatment of tinnitus: a systematic review

PURPOSE

Tinnitus is a common symptom with multiple causes and treatment options. Previous studies have investigated the effect of lidocaine iontophoresis. The aim of this review is to systematically present the effects on tinnitus and to derive possible effects.

METHODS

In accordance to the PRISMA statement, the search and analysis were performed. An abstract in German or English and a performed intervention with lidocaine iontophoresis for the treatment of tinnitus, independent of the study design, were considered as inclusion criteria. Due to the heterogeneity of the studies, only a narrative synthesis was performed.

RESULTS

The search yielded 179 studies of which 170 were excluded. Six full-texts and three abstracts were included. In total, 957 patients were treated with lidocaine iontophoresis. The percent improvement in symptoms after lidocaine iontophoresis ranged from 4% to 62%. The qualitative assessment of the studies resulted in an overall "weak" rating for all of them.

CONCLUSIONS

Due to the heterogeneity and the limited quality of the studies found, no clear statement can be made about the efficacy. The number of those who benefited from therapy varied widely. In addition, it cannot be ruled out that the effect was merely due to electrical stimulation of the cochlea.

Lidocaine intradermal injection--a new approach in tinnitus therapy: preliminary report

The efficacy of lidocaine in controlling tinnitus is well documented. It can be administered intravenously or by transtympanic injection. The first method of delivery can produce cardiovascular and central nervous system adverse reactions. The transtympanic injection can bring about slight sensorineural hearing loss, vertigo, vomiting, and taste disturbances. To improve on results obtained in persons with tinnitus, the vasoactive drug lidocaine was delivered by a novel intradermal route in 68 patients. The control group, which received intradermal saline injection, included 20 patients with tinnitus. As parameters of evaluation, the self-evaluation scale of subjective disturbance and tinnitus loudness were considered. Significant improvement in level of disturbance and tinnitus loudness was observed both in patients with tinnitus intensity less than 10 dB and in those with tinnitus intensity greater than 10 dB. No significant results were observed in the control group. Of particular interest was the complete absence of unpleasant complications with intradermal lidocaine.