The otologist performs the different operations within the external auditory canal under various difficulties. His field of operation is usually at the bottom of this deep and tortuous canal; the operations, while brief, are ordinarily very painful so that the patient is very apt to jerk his head and throw out of position the operator's carefully adjusted illumination and field of observation, resulting possibly in injury to neighboring structures. For these reasons, let alone the more humane one of saving the patient suffering, some form of anesthetic is desirable or at times even necessary.
Except in the case of young children or for delicate and complicated operations, the risk of a general anesthetic seems unwarranted. Solutions of cocain, or its equivalents, are absorbed but slowly and with difficulty by the skin surface of the canal and hypodermic injections are impractical for various and obvious reasons. A more suitable method of
SCHILD EH. ETHYL CHLORID ANESTHESIA OF THE MEMBRANA TYMPANI AND EXTERNAL AUDITORY CANAL.. JAMA. 1905;XLV(2):89-90. doi:10.1001/jama.1905.52510020009002a