By Marcello Cherchi, MD PhD
For patients
In some sicknesses it may be necessary to inject medication through the eardrum. The doctor first uses medication to numb the eardrum, then injects a different medication through the eardrum.
For clinicians
Overview
A transtympanic injection is a simple procedure performed by a neuro-otologist. This enables delivery of medication into the middle ear, such as steroids (for treating sudden sensorineural hearing loss or Ménière’s disease) or gentamicin (for treating Ménière’s disease). Risks include failure of the hole to heal; this is rare.
Introduction
In some circumstances a neuro-otologist may deem it necessary to deliver medication into the middle ear. The most common method for doing this is a transtympanic injection, sometimes also called an intratympanic injection. In order to do this the neuro-otologist applies a topical anesthetic to the tympanic membrane — usually phenol (Fina and Chieffe 2019) — then uses a fine gauge needle to inject the medication in question.
Common medications delivered in this way include steroids (such as dexamethasone) for treating sudden sensorineural hearing loss or Ménière’s disease, or gentamicin for treating Ménière’s disease.
Adverse effects
As with any invasive procedure, the risks of transtympanic injections include bleeding and infection. Performing a transtympanic injection necessarily creates a small hole in the tympanic membrane; this hole is small enough that it usually heals quickly, but in rare cases the hole remains or even enlarges, and may require repair.
References
Fina M, Chieffe D (2019) Office-Based Otology Procedures. Otolaryngol Clin North Am 52: 497-507. doi: 10.1016/j.otc.2019.02.004
