Anesthesiology for Middle Ear Surgery.
DOI:
https://doi.org/10.36557/2674-8169.2025v7n5p1560-1571Keywords:
Surgery, middle ear, general anesthesia, local anesthesia, complicationsAbstract
Middle ear surgery has evolved thanks to endoscopic techniques, impacting anesthesiology decisions, such as the use of general anesthesia (GA) or local anesthesia (LA). GA is chosen for longer surgeries to ensure patient immobilization and airway control, while LA favors faster recovery and lower costs in less complex procedures. To achieve an in-depth understanding of anesthesia in this surgery, a comprehensive review was conducted using electronic databases such as PubMed, Scopus, and Google Scholar, including articles from 2020 onward. The focus was on the anatomy and physiology of the middle ear, particularly its role in the transmission and amplification of sound. Physiological implications guide the choice between GA and LA, affecting the safety and efficacy of the procedure. GA is preferred for its ability to provide a stable surgical environment, while LA allows auditory evaluation of the patient during surgery, being less invasive. Preoperative and postoperative care focuses on pain and blood pressure control, which is crucial for patient recovery. This review highlights the importance of selecting the type of anesthesia according to surgical complexity and patient characteristics to optimize outcomes.
Downloads
References
REFERENCIAS.
Nogueira JF, de Sousa Lobo Ferreira Querido R, Gonçalves da Silva Leite J, Cabral da Costa T. Future of Endoscopic Ear Surgery. Otolaryngologic Clinics of North America [Internet]. 1 de febrero de 2021;54(1):221-31. Disponible en: https://www.sciencedirect.com/science/article/pii/S0030666520366974
Dixon PR, James AL. Evaluation of Residual Disease Following Transcanal Totally Endoscopic vs Postauricular Surgery Among Children With Middle Ear and Attic Cholesteatoma. JAMA Otolaryngology–Head & Neck Surgery [Internet]. 1 de mayo de 2020;146(5):408-13. Disponible en: https://doi.org/10.1001/jamaoto.2020.0001
Anschuetz L, Siggemann T, Dür C, Dreifuss C, Caversaccio M, Huwendiek S. Teaching Middle Ear Anatomy and Basic Ear Surgery Skills: A Qualitative Study Comparing Endoscopic and Microscopic Techniques. Otolaryngol Head Neck Surg [Internet]. 1 de julio de 2021;165(1):174-81. Disponible en: https://doi.org/10.1177/0194599820977191
Marchioni D, Rubini A, Soloperto D. Endoscopic Ear Surgery: Redefining Middle Ear Anatomy and Physiology. Otolaryngologic Clinics of North America [Internet]. 1 de febrero de 2021;54(1):25-43. Disponible en: https://www.sciencedirect.com/science/article/pii/S0030666520366779
Petrucci B, Okerosi S, Patterson RH, Hobday SB, Salano V, Waterworth CJ, et al. The Global Otolaryngology–Head and Neck Surgery Workforce. JAMA Otolaryngology–Head & Neck Surgery [Internet]. 1 de octubre de 2023;149(10):904-11. Disponible en: https://doi.org/10.1001/jamaoto.2023.2339
Kaur B, Clark MPA, Lea J. Anaesthesia for ear surgery in remote or resource-constrained environments. The Journal of Laryngology & Otology [Internet]. enero de 2019;133(1):34-8. Disponible en: https://www.cambridge.org/core/journals/journal-of-laryngology-and-otology/article/anaesthesia-for-ear-surgery-in-remote-or-resourceconstrained-environments/5E348E17EF829345DF16A6FA587A57AC
El-Begermy MA, El-Begermy MM, Rabie AN, Ezzat AEM, Kader Sheesh AA. Use of local anesthesia in ear surgery: technique, modifications, advantages, and limitations over 30 years’ experience. Egypt J Otolaryngol [Internet]. julio de 2016;32(3):161-9. Disponible en: https://ejo.springeropen.com/articles/10.4103/1012-5574.186541
Thota RS, Ambardekar M, Likhate P. Conscious sedation for middle ear surgeries: A comparison between fentanyl-propofol and fentanyl-midazolam infusion. Saudi J Anaesth [Internet]. 2015;9(2):117-21. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374213/
Kosare S. Anesthesia for Middle Ear Surgeries and Cochlear Implant. An International Journal of Otorhinolaryngology Clinics [Internet]. 1 de agosto de 2015;7(1):1-9. Disponible en: https://www.aijoc.com/abstractArticleContentBrowse/AIJOC/7/7/1/505/abstractArticle/Article
Pairaudeau C, Mendonca C. Anaesthesia for major middle ear surgery. BJA Educ [Internet]. mayo de 2019;19(5):136-43. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808081/
Rich JN, Allen ST, Rivera AL. Middle Ear Physiology. En: Kountakis SE, editor. Encyclopedia of Otolaryngology, Head and Neck Surgery [Internet]. Berlin, Heidelberg: Springer; 2013. p. 1686-8. Disponible en: https://doi.org/10.1007/978-3-642-23499-6_804
Sánchez López de Nava A, Lasrado S. Physiology, Ear. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK540992/
Kaur -Madan H, Kosare S. Anesthesia for Middle Ear Surgeries and Cochlear Implant. An International Journal of Otorhinolaryngology Clinics [Internet]. 1 de abril de 2015;7(1):1-9. Disponible en: https://www.aijoc.com/doi/10.5005/jp-journals-10003-1179
Chen X, Xie L, Zeng H, Xu Y, Xiong H. Local Versus General Anesthesia for Balloon Dilation of the Eustachian Tube: A Single-Center Retrospective Study in a Chinese Population. Ear Nose Throat J [Internet]. 19 de mayo de 2020;0145561320923172. Disponible en: https://doi.org/10.1177/0145561320923172
Emilio A, Max T, Rolf S, Giorgio L, De Luca P, Pasquale V, et al. Local anesthesia vs. general anesthesia in cochlear implant surgery: Impact on surgical duration, postoperative recovery, costs and clinical insights. An extensive meta-analysis. American Journal of Otolaryngology [Internet]. 1 de noviembre de 2024;45(6):104462. Disponible en: https://www.sciencedirect.com/science/article/pii/S0196070924002485
Toivonen J, Dean M, Kawai K, Poe D. Comparison of outcomes for balloon dilation of the Eustachian tube under local vs general anesthesia. Laryngoscope Investigative Otolaryngology [Internet]. 2022;7(4):1120-8. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1002/lio2.842
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Keiko Carolina Arévalo Quimí , Yesenia Estefania Arroyo Palacios , Kerly Sujeinne Jalón Morales , Roberto Carlos Rodríguez Arias , Gabriela Alejandra Silva Alcívar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.
