Assessment of intravenous lidocaine for the treatment of subjective tinnitus.

Despite the development of sophisticated diagnostic procedures and treatments for other otologic and neurotologic conditions, tinnitus remains difficult to manage. Several investigators have shown that lidocaine has an effect on temporarily (for several minutes) relieving subjective tinnitus, but few reports have described the response to lidocaine according to different individual patient characteristics. Over a 24-year period, we administered either 60 or 100 mg of intravenous lidocaine to 117 ears in 103 patients with subjective tinnitus (14 patients received treatment bilaterally). Within 5 minutes of treatment, 83 ears (70.9%) experienced either complete or partial relief. The 100-mg dose was more effective than the 60-mg dose in completely eliminating tinnitus (34.9 vs 20.6%), but the two doses were comparable when elimination rates were combined with rates of reduction of tinnitus (71.1 and 70.6%, respectively). With respect to individual patient characteristics, ears with low- to middle-tone tinnitus had a better response, as did ears in which the hearing level was 40 dB or higher and ears of patients aged 60 years and older. The response to lidocaine was not correlated with the baseline loudness of tinnitus or to its duration.