[Rheologic infusion therapy, neurotransmitter administration and lidocaine injection in tinnitus. A staged therapeutic concept].
OBJECTIVE
Cochlear dysfunction and tinnitus are treated by means of hemorrheological infusions in order to increase the cochlear oxygen supply and restore function of hair cells, neurotransmission and central processing of auditory information.


METHODS
In a retrospective analysis of the charts of 123 patients treated between February 1993 and May 1994, we analyzed effectiveness and safety of a gradual therapeutic regimen, consisting of dextrane/procaine infusions, lidocaine i.v. injection and infusion therapy with the neurotransmitter glutamic acid.


RESULTS
Tinnitus decreased in 83.7% of patients with acute tinnitus (AT) and 16.1% of patients with chronic tinnitus (CT) during dextrane/procaine infusion. The majority (89%) experienced their tinnitus relief during the first 5 days. Treatment with glutamic diethylester and glutamic acid resulted in a 26.5% overall improvement. Application of lidocaine intravenously over a period of 10 min diminished tinnitus loudness or frequency in 16.7% (AT) and 38.9% (CT) of cases respectively. The long-term effects of therapy were investigated by a follow-up mailing action: 66.7% of the AT and 15.6% of the CT sufferers stated a clear therapy effect over time. Nonserious side effects were noted in 4% of the treated patients. Therefore safety was excellent.


CONCLUSIONS
For acute and chronic tinnitus a gradual therapeutic regimen is recommended: (1) infusions with dextrane and procaine over 5 days; (2) intravenous application of 100 mg lidocaine over 10 min; and if necessary (3) administration of glutamic diethylester and glutamic acid for 3 days. This resulted in overall tinnitus relief in 95.3% of the acute and 26.7% of the chronic tinnitus sufferers.
Arzt für HNO-Heilkunde, spezielle HNO-Chirurgie und plastische Operationen, Geibelstrasse 42, 12305 Berlin. Th.Wilhelm-ORL.HNS@gmx.net
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Wilhelm
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Agababov
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Lenarz
D000293:Adolescent; D000328:Adult; D000368:Aged; D003051:Cochlea / Q000098:blood supply* / Q000187:drug effects; D003911:Dextrans / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D018698:Glutamic Acid / Q000008:administration & dosage*; D006198:Hair Cells, Auditory / Q000098:blood supply* / Q000187:drug effects; D018056:Hemorheology; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011343:Procaine / Q000008:administration & dosage*; D014012:Tinnitus / Q000188:drug therapy* / Q000209:etiology
D003911:Dextrans; D018698:Glutamic Acid; D011343:Procaine; D008012:Lidocaine