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Assessing ototoxicity and patients’ satisfaction of topical local anaesthesia in myringotomy and ventilation tube insertion

Published online by Cambridge University Press:  02 April 2019

S Marzouk*
Affiliation:
Department of ENT, East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK
A Al-lami
Affiliation:
Department of ENT, East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK
R Sykes
Affiliation:
Department of ENT, East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK
C Neumann
Affiliation:
Department of ENT, East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK
I J Nixon
Affiliation:
Department of ENT, East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, UK
*
Author for correspondence: Dr Sherief Marzouk, Department of ENT, East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford TN24 0LZ, UK E-mail: marzouksherief@googlemail.com

Abstract

Objectives

Animal studies have suggested that exposure of the middle ear to topical local anaesthesia may be ototoxic. This study aimed to report sensorineural hearing outcomes and patients’ satisfaction in those who underwent myringotomy and ventilation tube insertion using topical local anaesthesia.

Methods

Twenty-nine patients (32 ears) were operated on. Pre- and post-operative audiology findings were compared. A Likert-type questionnaire on treatment satisfaction was completed at the end of the procedure.

Results

Median patient age was 55 years (range, 27–88 years). Pre- and post-operative bone conduction pure tone averages were 26.76 dB and 25.26 dB respectively (mean reduction of −1.22 dB, 95 per cent confidence interval of −5.91 to 8.13 dB; p = 0.7538). One ear (3 per cent) had a reduction in pure tone average of 10 dB.

Conclusion

The results suggest that sensorineural hearing loss is not a complication of ear exposure to topical local anaesthesia during myringotomy and ventilation tube insertion. The procedure was well perceived.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr S Marzouk takes responsibility for the integrity of the content of the paper

References

1NHS England. Commissioning Services for People with Hearing Loss: A Framework for Clinical Commissioning Groups. In: https://www.england.nhs.uk/wp-content/uploads/2016/07/HLCF.pdf [2 June 2016]Google Scholar
2Nichani, J, Camilleri, AE, Broomfield, S, Saeed, S. Optimizing local anesthesia for grommet insertion: eutectic mixture of local anaesthetics versus Ametop. A randomized clinical trial. Otol Neurotol 2008;29:658–60Google Scholar
3Hoffman, C-L. Tetracaine topical anesthesia for myringotomy. Laryngoscope 2001;111:1636–8Google Scholar
4National Collaborating Centre for Women's and Children's Health (commissioned by the National Institute for Health and Clinical Excellence). Surgical Management of Otitis Media with Effusion in Children. London: RCOG Press, 2008;31Google Scholar
5Han, WW, Incesulu, A, McKenna, MJ, Rauch, SD, Nadol, JB Jr, Glynn, RJ. Revision stapedectomy: intraoperative findings, results, and review of the literature. Laryngoscope 1997;107:1185–92Google Scholar
6Timms, MS, O'Malley, S, Keith, AO. Experience with a new topical anaesthetic in otology. Clin Otolaryngol 1988;13:485–90Google Scholar
7Albrecht, W. Anaesthesia for surgery of the ear [in German]. Archiv Ohrenheilkde 1911;85:198215Google Scholar
8Comeau, M, Brummett, R, Vernon, J. Local anesthesia of the ear by iontophoresis. Arch Otolaryngol 1973;98:114Google Scholar
9Anniko, M, Schmidt, SH. The ototoxic potential of EMLA. A new local anesthetic for the tympanic membrane. Acta Otolaryngol 1988;105:255–65Google Scholar
10Anniko, M, Hellström, S, Schmidt, SH, Spandow, O. Toxic effects on inner ear of noxious agents passing through the round window membrane. Acta Otolaryngol Suppl 1989;457:4956Google Scholar
11Schmidt, SH, Anniko, M, Hellstrom, S. Electrophysiological effects of the clinically used local anesthetics lidocaine, lidocaine-prilocaine and phenol on the rat's inner ear. Eur Arch Otorhinolaryngol 1990;248:8794Google Scholar
12Roberts, C, Carlin, WV. A comparison of topical EMLA cream and prilocaine injection for anaesthesia of the tympanic membrane in adults. Acta Otolaryngol 1989;108:431–3Google Scholar
13Bingham, B, Hawke, M, Halik, J. The safety and efficacy of Emla cream topical anesthesia for myringotomy and ventilation tube insertion. J Otolaryngol 1991;20:193–5Google Scholar