Evaluation of Adding Lidocaine to Dexamethasone in the Intra-tympanic Injection for Management of Tinnitus: A Prospective, Randomized, Controlled Double-blinded Trial.

OBJECTIVES: Assessment of adding lidocaine to dexamethasone in the intratympanic injections for the treatment of subjective idiopathic tinnitus (SIT).

METHOD: A prospective, controlled, randomized, double-blind study of forty-four patients with SIT diagnosed in the Department of Otolaryngology, Tanta University Hospital, a tertiary academic medical centre from March 2015 to October 2016. 44 patients were recruited in the study and were categorized into two groups; (A) included 22 patients managed with ITLD, and (B) included 22 patients managed with intratympanic postoperative ITD injection. Intratympanic injections were double-blind performed three times with one weak interval. After three and six months, the tinnitus improvement was studied using the following parameters: Arabic tinnitus questionnaires (ATQ), loudness matching test and Tinnitus handicap index (THI).

RESULTS: The effectiveness rates of ITLD for idiopathic tinnitus reported in the ATQ, THI, and in the loudness matching test were 74.5% in the ITDL group and 50.0%, 50.5%, and 40.0% in the ITD group, respectively. Statistically, there was a significant difference between both groups in 6 months duration.

CONCLUSION: ITLD seems to be effective for SIT than ITD alone. The indication of ITLD for tinnitus needs to be limited to specific cases of resistant medical treatment.