Experience with a new topical anaesthetic in otology

Abstract

Producing good local anaesthesia of the external auditory meatus and tympanic membrane has always been a difficult problem facing otologists. Previously used methods are mentioned and the use of a new eutectic mixture of local anaesthetics (EMLA) for electrocochleography, myringotomy and grommet insertion in adults and older children is described. A double-blind controlled trial involving 15 patients (30 ears) undergoing electrocochleography showed EMLA to be a very effective, safe and convenient preparation for outpatient otological use.

Effect of the Topical Anesthetic EMLA on the Efficacy of Pulsed Dye Laser Treatment of Port‐Wine Stains

“…EMLA cream has been shown to be effective in decreasing the subjective assessment of pain of venepuncture, 1–7 myringotomy placement, 8,9 split‐thickness skin grafting, 10–12 curettage of molluscum contagiosum in children, 13 cautery of genital warts, 14 and the pain of argon laser treatment 15 . EMLA cream has also been found to be nontoxic and to have plasma levels in the general circulation up to 100 times lower than those associated with toxicity 16,17 .…”

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

“…The provision of safe and effective local anaesthetic to the external ear canal and tympanic membrane has been pursued since the end of the nineteenth century 6 . Those efforts began in 1884 with Zaufel, who anaesthetised the tympanic membrane with cocaine dissolved in alcohol after applying a macerating solution to the keratinised outer layer 6 .…”

“…The provision of safe and effective local anaesthetic to the external ear canal and tympanic membrane has been pursued since the end of the nineteenth century 6 . Those efforts began in 1884 with Zaufel, who anaesthetised the tympanic membrane with cocaine dissolved in alcohol after applying a macerating solution to the keratinised outer layer 6 . A similar approach was adopted with the advent of Bonain's solution, which combined cocaine with phenol and menthol; this would be used to necrotise the superficial layers of the tympanic membrane and anaesthetise deeper layers.…”

“…A similar approach was adopted with the advent of Bonain's solution, which combined cocaine with phenol and menthol; this would be used to necrotise the superficial layers of the tympanic membrane and anaesthetise deeper layers. Whilst being as effective as anaesthetic agents, their use carried significant risks, including tympanic membrane perforation, vestibulocochlear damage, facial nerve palsy and toxicity 6 . Despite this, they were adopted widely in the first half of the twentieth century.…”

Topical Anaesthesia of the Normal Tympanic Membrane: A Controlled Clinical Trial of Different Suspensions of Lidocaine

“…However, rat experi ments have shown enduring eardrum dam age for up to 5 months after application [7][8][9], and hence it has not been recommended for human use [7], Recently, an ointment suspension of lido caine and prilocaine (EMLA) [10] proved to be effective, but animal experiments have shown cochlear damage [11].…”