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Office-Based Middle Ear Surgery Under Local Anesthesia: A Contemporary Review.

Naif Bawazeer1

  • 1Department of Otolaryngology - Head and Neck Surgery and Ophthalmology, College of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia.

Journal of Clinical Medicine Research
|August 14, 2025
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Summary

Local anesthesia (LA) offers a feasible alternative to general anesthesia (GA) for middle ear surgery, particularly in office-based settings. This approach enhances patient safety, reduces costs, and allows for immediate feedback during procedures.

Keywords:
Local anesthesiaMiddle ear surgeryOffice-based surgerySedation

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Area of Science:

  • Otolaryngology
  • Surgical Anesthesia

Background:

  • Middle ear surgery is a common otolaryngology procedure where pain control and a stable operative field are essential.
  • General anesthesia (GA) is typically used, but local anesthesia (LA) presents a viable alternative, especially for office-based procedures.

Purpose of the Study:

  • To review the literature on the feasibility of performing middle ear surgeries under local anesthesia (LA) in an office-based setting.
  • To provide a concise guide for implementing LA in middle ear surgery, covering techniques, advantages, and limitations.

Main Methods:

  • A scoping review of existing literature was conducted.
  • The review focused on the feasibility, advantages, surgical techniques, limitations, and outcomes of middle ear surgery performed under LA in an office setting.

Main Results:

  • Local anesthesia (LA) is a feasible option for middle ear surgery in an office setting.
  • LA avoids rare but serious complications associated with general anesthesia (GA) and offers significant cost savings.
  • LA allows for real-time surgeon feedback on hearing and prosthesis fit, potentially preventing complications like a dead ear.

Conclusions:

  • Office-based middle ear surgery under LA is feasible and offers numerous benefits over GA.
  • LA is an ideal alternative when operating room access is limited, staff are scarce, or GA is contraindicated.
  • This review provides practical guidance for surgeons considering LA for middle ear procedures, aiming for optimal patient care and outcomes.