Anyone who has done myringotomy using available local anesthetic agents has found that these materials are totally inadequate in yielding any degree of numbness to the eardrum. Skin covers the external surface of the eardrum, and it is well known that its keratinized surface layer is impermeable to topical anesthetic agents. It is because of this impermeability of the skin that available materials fail to provide adequate anesthesia.
Proprietary preparations containing synthetic anesthetic agents with antibiotics and other ingredients have certainly been ineffective in yielding any numbness to the tympanic membrane. There has been some success with the use of Bonaine's solution, which is composed of equal parts of pure phenol, menthol, and cocaine. Because of reports of sloughing of the normal eardrum its use has never been popular. The use of cocaine in freshly prepared aniline was first described by A. A. Gray of London, in his paper on
OCHS IL. Topical Anesthesia for Myringotomy. Arch Otolaryngol. 1966;83(1):57. doi:10.1001/archotol.1966.00760020059018
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