Release: May 12, 2000
Contact: Kenneth Satterfield, 407-238-4161 (as of 5/12/2000)
LIDOCAINE PROVIDES SIGNIFICANT RELIEF TO TINNITUS SUFFERERS
A new treatment injecting lidocaine in the inner ear and intravenously offers eliminates or alleviates the noise that cannot be heard by others
Orlando, FL -- Severe tinnitus gives the patient a perception of sound that is not present in the environment. The causes for this disorder are many; tinnitus is characterized by a deterioration of the hair cells of the cochlea, causing an alteration in the activity of the reflex pathway from the hair cells to the auditory cortex and back. No consensus exists whether tinnitus is caused by the hair cells, auditory pathway, or the central nervous system.
A new study suggests that all three contribute to this condition. The medical researchers also have developed a new treatment injecting lidocaine in the inner ear and intravenously, that has offered significant relief to those suffering from intractable tinnitus.
The authors of the study, "Lidocaine Perfusion of the Inner Ear plus IV Lidocaine or Intractable Tinnitus," are John J. Shea, MD, and Xianxi Ge, MD, both from the Shea Ear Clinic, Memphis, TN. Their findings were presented before the American Otological Society, meeting May 13-14 in Orlando, FL.
Methodology: From December, 1994, to July, 1996, 71 ears of 68 patients with intractable tinnitus were treated by lidocaine perfusion of the inner ear and with intravenous lidocaine. Specifically, approximately 0.5 ml of hyaluronan (Amvisc(r)) containing 20 mg of lidocaine per milliliter was injected into the round window niche. The patient then remained with the operated-ear positioned up while receiving 500 mg of lidocaine intravenously for two hours. This procedure is repeated for three consecutive days; hearing and spontaneous nystagmus are tested on the second and third days.
Thirty four patients were male, thirty-four female; the age of the subjects ranged from 37 to 83 years with a mean of 59.9 years. Sixty-five patients had tinnitus in one ear; three in both ears. The duration of tinnitus for the subjects was less than one year for 15 ears, one to ten years in 30 ears, and more than 10 years in 26 ears. A detailed medical history and neurotological evaluation was conducted on each patient.
The causes for tinnitus varied. Sensorineural hearing loss (SNHL) without an obvious cause was present in 12 ears and associated with acoustic trauma in ten ears. Other causes for the tinnitus included Meniere's disease, sudden hearing loss and congenital SNHL. The researchers divided the tinnitus into two categories: High-tone included ringing, hissing, whistling, ticking and was present in 40 of 71 ears; low-tone caused roaring, buzzing, popping, swishing, and sounds of seashore surf and wind could be found in 31 ears.
The criteria for judging the improvement was subjective, depending on feedback from the patient provided during follow-up examinations. Depending on the patient's response, improvement was characterized as complete relief (no more tinnitus), partial relief (intermittent occasionally troublesome tinnitus), and no relief (tinnitus remains the same).
Results: Key findings of the study are:
ï Tinnitus relief, complete or partial, was achieved in 35 of 50 (70 percent) ears in one month, in 20 of 26 (76.9 percent) ears tested at three months, and ten of 12 ears tested at one year (83.3 percent), all resulting from lidocaine perfusion of the labyrinth through the middle ear (some patients had their afflicted ears tested more than once leading to a number >71).
ï Tinnitus associated with Meniere's disease, positional vertigo, post-stapedectomy, and aspirin intake was present in 22 ears. Complete relief was achieved in three of 22 ears (13.6 percent), partial relief in 15 ears (68.2 percent) and no relief in four ears (18.2 percent).
ï Tinnitus associated with SNHL and viral labyrinthitis was present in 21 ears. Complete relief was found in two ears (9.5 percent), partial relief in eight (38.1 percent) and no relief in 11 (52.4 percent).
ï More relief was achieved in better hearing ears.
Conclusion: The authors suggest that lidocaine perfusion of the labyrinth through the middle ear plus intravenous lidocaine is an effective treatment for tinnitus associated with various inner ear diseases, especially those involving the hair cells.
- end -
RSS