Local anesthesia of the head and neck

In theory, most ear, nose, and throat surgery involving the soft tissues of the head and neck may be performed under local anesthesia. This includes surgery on the middle ear, even mastoidectomy; partial or total laryngectomies; surgery on the nose and paranasal sinuses; and surgery on the major salivary glands. For this purpose, local anesthetics, with or without epinephrine, are administered either by infiltration injection or by topical application. The selection of either local or general anesthesia for a surgical procedure will depend on many important factors, not the least of which is the preference of the patient. This paper presents factors to be considered in making this choice, as well as surgical indications and contraindications to the use of local anesthesia.