Effectiveness of Intratympanic Lidocaine and Dexamethasone in Idiopathic Tinnitus: A Randomized Double-Blind Placebo-Controlled Trial

Background: Tinnitus is a common problem and complaint in otolaryngology, often with no identifiable cause. While various treatments for tinnitus have been investigated, only a limited number have demonstrated relative success. Intratympanic injection of various drugs is one such treatment that has yielded contradictory results in studies. Objectives: In this study, the effect of intratympanic injection of dexamethasone, lidocaine, and placebo was investigated. Methods: A randomized, double-blind clinical trial was conducted, assigning patients with idiopathic tinnitus to 3 groups: dexamethasone, lidocaine, or saline placebo. Participants received 4 intratympanic injections over a 2-week period, following a predefined protocol. Tinnitus severity was evaluated using the Tinnitus Handicap Inventory (THI) at baseline, 2 weeks, 1 month, and 3 months postintervention. Results: Data from all randomized participants were analyzed primarily according to the intention-to-treat principle, with 127 patients completing the full study protocol. Baseline characteristics were evenly distributed across the 3 groups. Repeated-measures analysis of variance revealed a slight reduction in THI scores within each group (approximately 3 points, P < 0.001). However, no statistically significant difference was observed in THI reduction between the dexamethasone, lidocaine, and placebo groups ( P = 0.746), suggesting that the type of injected drug did not significantly impact tinnitus improvement. Conclusion: This study indicates intratympanic dexamethasone and lidocaine were not superior to placebo in alleviating tinnitus symptoms. Given the lack of significant difference between treatment groups, further research is warranted to explore alternative therapeutic strategies and the potential efficacy of other pharmacological agents for tinnitus management.