Myringotomy requires analgesia of the tympanic membrane, this is particularly true in children.
Comeau et al revived the method of iontophoretic anesthesia by making a new apparatus. Accoridng to their paper, numerous painless myringotomies were performed in patients ranging in age from 2 1/2 years to adulthood without any major complications.
Included in the present study were thirty-nine patients with serous otitis media (42 ears) and eleven patients with Meniere's disease (14 ears). The former group consisted of twenty-four males (27 ears, 4-78 years old) and fifteen females (15 ears, 4-65 years old). The latter group consisted of two males (2 ears, 29-54 years old) and nine females (12 ears, 31-72 years old).
An iontophoretic applicator (Medical System Ltd. U. S. A.) was used for anesthesia of the tympanic membrane in these patients.
The effectiveness of analgesia of the tympanic membrane by iontophoresis was judged by the degree of pain during myringotomy and ventilatory tube insertion in the group of serous otitis media, and by rubbing the tympanic membrane with the tip of the probe in patients with Meniere's disease.
In all cases, tube insertion or tympanic membrane stimulation was performed without pain.
The author considers that inotophoretic anesthesia of the tympanic membrane with lidocaine is a painless and safe method for myringotomy and ventilatory tube insertion.
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