For tympanocentesis, I usually prefer the 4 quadrant auditory canal block supplemented by benzocaine otic gtt.
On a related note, could you clarify what you meant by "AOM with secondary OE...?" It is either perforative AOM or OE. The two entities are pathophysiologically and clinically distinct.
> From: "Cordle, Randy" <[log in to unmask]>
> Subject: Otitis continued...
> Thanks to Dr. Arnold for pointing out that I was not at all clear about
> which diagnosis I was talking about at various points in my reply. I
> agree with his point. If AOM with secondary OE then let it drain, but
> clearing debris is sometimes helpful sans wick. If primary OE then let
> it drain, clear canal when needed and use wick when in indicated. I
> have seen the wick wind up deeper in the ear with some discomfort and
> removed them for this reason but it maybe that they would have fallen
> out on their own eventually anyway. I removed them because the thought
> of having a mini-tampon in the ear against the TM for a ? period of time
> caused me to get "anxious" about leaving it in. This is why I started
> using the suture trick. No worries about it getting lost.
> On a related topic......what is the group's favorite choice for TM
> analgesia for tympanocentesis?
> Randy Cordle MD
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