SURGERY on the intact tympanic membrane is usually performed without anesthesia on infants and adults or under general anesthesia in children. Neither method is entirely satisfactory but is continued because a safe and painless technique for local anesthesia has not been available. Although infiltration of the ear canal skin is effective, the pain on administration limits its use in children. Topical anesthesia would be useful in children if the agent could be dropped into the ear canal as a liquid without discomfort. Of the many topical agents that have been tried (Uhde1), none are used widely today because they are either ineffective, or caustic to tissues as phenol when used in 30% solution in Bonain's solution or 100% phenol as recently reported by Storrs.2
The tympanic membrane, as all keratinizing epithelial surfaces, is impermeable to agents applied topically as long as its structure remains intact. Cutaneous permeability
Abramson M. Topical Anesthesia of the Tympanic Membrane. Arch Otolaryngol. 1969;90(2):147–149. doi:10.1001/archotol.1969.00770030149009
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