Intra tympanic injection means using a needle to pierce the ear drum and squirt medication into the middle ear. Tympanic is another word for ear. Intra tympanic means inside the ear.
Your doctor may recommend intra tympanic injection of steroid for
- sudden sensorineural hearing loss not improving after 14 days of tablet steroid, or
- acute Meniere’s disease symptoms.
Allow 90 minutes for the procedure. You do not need to fast and you can drive yourself home after the procedure.
The surgeon makes your ear drum numb
- EMLA or local anaesthetic cream is painted onto the ear drum and ear canal. Your ear will feel blocked while the cream is in place. It takes 45-60 minutes for the cream to work. You can wait at the practice or leave and return 50 minutes later.
You will lie down with the head elevated and turned to one side, away from the side of the injection. The surgeon uses a microscope
- the cream is removed with microsuction
- the surgeon checks with you to ensure the drum feels numb
- then injects the steroid liquid
What you will feel
- suction is very noisy
- you may feel light pressure but will not feel pain
- the liquid will feel cool, and you may feel or taste it in the back of the mouth
- temporary side effects lasting minutes: some people feel nausea, tinnitus (noise in the ear) or dizzy or vertigo for a few minutes with each injection. Warming the medication to body temperature before injection can reduce the chance of feeling vertigo
You stay in the same position, keeping your head turned to one side for 15 minutes.
You can then go home. It’s safe to drive, return to work, eat and drink as normal and take your usual medications after the procedure.
It’s normal to have a small amount of watery discharge from the ear for 1 day.
Intra tympanic injections give the benefit of high dose steroid while avoiding the systemic or total body side effects of using steroid tablets.
Long term side effects:
The tiny needle hole in the ear drum usually heals within 48 hours. There is a 1:100 chance that the hole does not heal. It is rare for a needle hole in the ear drum to cause symptoms or hearing loss and for most people no treatment is needed. If you do have a hole that does not heal and it is causing you symptoms, a myringoplasty can be considered (day stay endoscopic ear surgery – key hole surgery- in hospital).
In a meta-analysis (analyses many individual research papers), one person out of 805 people had permanently worse hearing after injection (4 out of 2415 people developed hearing loss or worse hearing after injection, 1 person improved back to normal and three people had permanent hearing loss).
Depending on your health problem and your response to the first injection, the surgeon may recommend up to 4 injections over 2-4 weeks for one course of treatment.