Intratympanic injections are becoming increasingly acceptable in the management of Meniere’s disease, tinnitus and sudden hearing loss. This is because they avoid the need for hospitalisation and can be performed as low-cost outpatient procedures. It is traditional to freeze the external auditory canal. This can be time consuming, especially if Emla cream is used. This study compares the use of 10% lidocaine spray and subcutaneous injection of 1% lidocaine with 1:100,000 adrenaline with no anaesthesia at all. VAS pain scores were taken five and forty-five minutes after the procedure. Apart from lower five-minute post-injection pain score with lidocaine spray, no significant difference was noted between any of the three methods. An equal number of patients preferred lidocaine spray and no anaesthesia as first choice. Lidocaine injection was the least preferred method, followed by no anaesthesia. Referral is made to a similar study which showed preference for no anaesthesia at all. These results if followed would render the procedure even more convenient than it is, but it would be helpful to know how well the injection sting was tolerated in addition to the postoperative pain, which is important to make a precise and adequate injection.

Effects of two different local anaesthetic methods vs no anaesthesia on pain scores for intratympanic injections.
Ata N, Erdur O, Gorgulu MH, Yilmaz E.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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