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经鼓膜向鼓室注入4%利多卡因治疗耳蜗性耳鸣。

Treatment of cochlear tinnitus with transtympanic infusion of 4% lidocaine into the tympanic cavity.

作者信息

Sakata H, Kojima Y, Koyama S, Furuya N, Sakata E

机构信息

Department of Otolaryngology, Teikyo University School of Medicine, Ichihara Hospital, Ichihara, Chiba, Japan.

出版信息

Int Tinnitus J. 2001;7(1):46-50.

Abstract

Tinnitus is an otological symptom that is encountered often, yet its treatment is difficult. If tinnitus is of cochlear origin, a reasonable assumption is that a total depression of the cochlear function will abolish cochlear tinnitus. To achieve this depression, transtympanic infusion of a local anesthetic (4% lidocaine) to anesthetize the inner ear was conducted in a patient suffering from tinnitus. Transtympanic infusion of 4% lidocaine was performed as a treatment for cochlear tinnitus, and its efficacy was investigated. The overall efficacy rate for the 292 patients with 369 affected ears was 81%. In the investigation of the treatment results in cases of different underlying ear diseases, the efficacy rate was high for tinnitus accompanying sudden deafness and labyrinthine vertigo. However, vestibular symptoms, such as vertigo and nausea, developed after lidocaine infusion. No permanent side effects were noted. Lidocaine infusion is thought to be a useful treatment option for tinnitus and should be considered before surgical treatment. Inner ear anesthesia into the tympanic cavity has been carried out in patients who had cochlear tinnitus and in whom conservative methods of therapy, such as oral medication, had proved unsuccessful. This treatment method is useful as a local therapy for cochlear tinnitus.

摘要

耳鸣是一种常见的耳科症状,但其治疗却很困难。如果耳鸣起源于耳蜗,那么合理的推测是耳蜗功能的完全抑制将消除耳蜗性耳鸣。为了实现这种抑制,对一名耳鸣患者进行了经鼓膜注入局部麻醉剂(4%利多卡因)以麻醉内耳的操作。进行经鼓膜注入4%利多卡因作为耳蜗性耳鸣的一种治疗方法,并对其疗效进行了研究。292例患者的369只患耳的总体有效率为81%。在对不同潜在耳部疾病病例的治疗结果进行调查时,突发性耳聋和迷路性眩晕伴发的耳鸣有效率较高。然而,利多卡因注入后出现了眩晕和恶心等前庭症状。未观察到永久性副作用。利多卡因注入被认为是耳鸣的一种有用治疗选择,在手术治疗前应予以考虑。对于患有耳蜗性耳鸣且口服药物等保守治疗方法已证明无效的患者,已进行了鼓室内内耳麻醉。这种治疗方法作为耳蜗性耳鸣的局部治疗是有用的。

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