Tetracaine topical anesthesia for myringotomy

Objectives/Hypothesis. To study the efficacy and safety of topical tetracai ne anesthesia for office myringotomy and myringotomy with a tube. Study Des ign: Retrospective review of patients undergoing office myringotomy, with o r without tube insertion, performed over a 4-year period. Methods. A topica l solution of 8% tetracaine base in 70% isopropyl alcohol was used in 381 e ars. Five to 10 drops of the solution were applied to the tympanic membrane for 10 to 15 minutes and aspirated. Myringotomy was performed either with a myringotomy knife or with a CO2 laser (OtoLAM). Results. Topical tetracai ne was used in all 231 ears (100%) undergoing myringotomy without a tube an d 150 of 212 ears (71%) undergoing myringotomy with a tube. Tetracaine alon e was effective in providing tympanic membrane anesthesia in 95% of myringo tomy without a tube (220 ears) and in 93% of myringotomy with a tube (139 e ars). There were six complications, including five cases of severe vertigo and one unusual prolonged, transient facial nerve weakness. Conclusion: Top ical tetracaine is efficacious and safe for use in office myringotomy.