Anesthesia and Surgical Field

The choice of anesthesia depends on the patient, the pathology, the type of surgery, and the surgeon’s and anesthetist’s usual practice and their experience.

In the majority of cases, general anesthesia is used. Local anesthesia is employed in simple cases, such as transcanal functional revision surgery or transcanal myringoplasty in adults.

General anesthesia is always combined with infiltration of local anesthetic.

Injection Technique

Local anesthesia is achieved by injection of 1% lidocaine and epinephrine 5 µg/mL prior to sterilization and draping.

The Plester technique is used (Plester 1963), which consists of four subperiosteal injections to the ear canal wall at 12, 3, 6, and 9 o’clock.