Gnuechtel M M, Schenk L L, Postma G N
Guadalupe Physicians Group, Kerrville, Tex, USA.
Arch Otolaryngol Head Neck Surg. 2000 Jun;126(6):733-5. doi: 10.1001/archotol.126.6.733.
The optimal local anesthetic for myringotomies or the insertion of tympanostomy tubes in adults should be easy and rapid to use, be painless during application, provide good anesthesia, be reversible, be inexpensive, and not cause any long-term damage to the tympanic membrane (TM).
To evaluate the histologic effects of topical anesthetic agents on the healing of the TM after myringotomy.
Sixty male albino guinea pigs were randomly assigned to 1 of 5 groups. Of the 5 groups, 2 were used as controls: one group underwent a myringotomy and the other group did not. The remaining 3 groups had both TMs treated with a topical anesthetic (phenol, tetracaine base, and eutectic mixture of lidocaine and prilocaine in a cream) prior to myringotomy. All TMs were inspected periodically and then harvested at 3 months or 6 months postoperatively for histologic examination.
The TMs of the group treated with tetracaine appeared the most normal at 6 months (P=.001). However, histologic evaluation failed to demonstrate any significant differences in the thickness of the TM or the lamina propria (P=.45), the amount (P=.80) and orientation (P=.07) of collagen, or the number of infiltrating lymphocytes (P=.70).
Based on the histologic findings, all 3 topical anesthetic agents appear to cause equivalent changes to the TM when used for a myringotomy.
用于成人鼓膜切开术或鼓膜造孔管插入术的最佳局部麻醉剂应易于快速使用，应用过程中无痛，提供良好的麻醉效果，可逆，价格低廉，且不会对鼓膜（TM）造成任何长期损害。
评估局部麻醉剂对鼓膜切开术后鼓膜愈合的组织学影响。
60只雄性白化豚鼠随机分为5组中的1组。在这5组中，2组用作对照：一组进行鼓膜切开术，另一组不进行。其余3组在鼓膜切开术前均用局部麻醉剂（苯酚、丁卡因碱以及利多卡因和丙胺卡因的共熔混合物乳膏）处理双侧鼓膜。定期检查所有鼓膜，然后在术后3个月或6个月采集进行组织学检查。
丁卡因处理组的鼓膜在6个月时看起来最正常（P = .001）。然而，组织学评估未能显示鼓膜或固有层厚度（P = .45）、胶原蛋白含量（P = .80）和方向（P = .07）或浸润淋巴细胞数量（P = .70）有任何显著差异。
根据组织学结果，所有3种局部麻醉剂用于鼓膜切开术时似乎对鼓膜造成同等程度的改变。
