Middle ear injections

What Are Middle Ear Injections?

Middle ear injections involve delivering medications such as corticosteroids or gentamicin directly into the middle ear through the eardrum. This minimally invasive procedure is performed by an ENT specialist to treat specific conditions affecting hearing or balance. Below is an overview of the process and its indications:

1. Middle Ear Injections with Corticosteroids:

Procedure:

  • Preparation: The patient is positioned comfortably, and the ear is carefully cleaned to ensure a sterile environment.
  • Anesthesia: A local anesthetic is applied to the ear canal and eardrum to minimize discomfort.
  • Injection: A small needle punctures the eardrum, creating a tiny opening (myringotomy), through which a corticosteroid solution (typically dexamethasone) is injected into the middle ear.
  • Post-Procedure: Patients are advised to avoid excessive water exposure to the ear for a few days. The eardrum heals naturally within a short period.

Indications:

  • Sudden Sensorineural Hearing Loss (SSNHL): Corticosteroids reduce inflammation and improve hearing outcomes in cases of sudden deafness.
  • Autoimmune Inner Ear Disease (AIED): An immune-mediated condition causing progressive hearing loss, corticosteroids suppress the immune response to preserve hearing.
  • Ménière’s Disease: Used to manage symptoms such as vertigo, hearing loss, and tinnitus.
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2. Middle Ear Injections with Gentamicin:

Procedure:

  • Preparation: The ear is cleaned and prepared similarly to corticosteroid injections.
  • Anesthesia: Local anesthesia numbs the ear canal and eardrum.
  • Injection: A fine needle punctures the eardrum, and gentamicin (an antibiotic) is injected into the middle ear.
  • Post-Procedure: Patients may be asked to lie on the opposite side to allow even distribution of the medication into the inner ear. The eardrum heals naturally over the following weeks.
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Indications:

  • Ménière’s Disease: Used as a last resort to reduce severe vertigo episodes when other treatments fail, gentamicin affects balance-related cells in the inner ear.
  • Superior Semicircular Canal Dehiscence (SSCD): In cases of thinning or absence of bone in the inner ear, gentamicin injections may alleviate symptoms.

Important Notes:

  • The decision to proceed with injections is made on a case-by-case basis, considering the patient’s condition, symptoms, and response to prior treatments.
  • Benefits and potential risks (e.g., permanent eardrum perforation or gentamicin’s impact on hearing) should be discussed with the doctor beforehand.

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