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.