Intratympanic perfusion for the treatment of tinnitus.

Intratympanic treatment of tinnitus with corticosteroids or gentamicin should be considered as an option of treatment in selected tinnitus patients, alone or in combination with standard modalities of management such as tinnitus retraining therapy, masking, and hearing aid amplification. Review of the literature and the authors' experience suggest the following points regarding intratympanic treatment for tinnitus: 1. Lidocaine, although effective in decreasing tinnitus, has been largely abandoned because of its severe side-effect profile and need for inpatient administration. 2. Corticosteroids have been associated with few if any side effects. 3. The good results reported in the literature with intratympanic steroids for treating tinnitus of various causes should be viewed with caution,because most are retrospective and uncontrolled studies. 4. Some Meniere's disease patients with tinnitus may experience tinnitus improvement following intratympanic steroids. This treatment may be considered in such patients, especially for those with good hearing. 5. Gentamicin is effective in eliminating or reducing tinnitus in a significant number of patients with Meniere's disease and may be considered especially for those with nonserviceable hearing. 6. Further prospective, randomized, and controlled studies to evaluate the effect of intratympanic perfusion for the treatment of tinnitus are warranted.