Role of tympanic neurectomy in otalgia

Tympanic neurectomy was first described 44 years ago. Although its indications have subsequently increased, it has not become a popular procedure. This paper concentrates on its use in treating otalgia. The history of tympanic neurectomy, the anatomy of the tympanic plexus and the aetiology of otalgia with specific reference to the tympanic plexus are discussed and a case of bilateral otalgia due to glossopharyngeal neuralgia successfully treated by staged, bilateral tympanic neurectomy reported. It is suggested tympanotomy performed under local anaesthesia with selective stimulation of the intra-tympanic nerves may lead to accurate diagnosis and treatment of the various forms of neuralgic otalgia.