Tympanic cavity ultraphonophoresis in cases of preserving integrity of tympanic membrane

Abstract

One of the most common treatments for the middle ear disorders is the injection of medications into the tympanic cavity through the acoustic meatus. This method has proven itself in treatment of the perforated forms of otitis. In cases of preserving the integrity of the tympanic membrane, its efficacy is arguable due to the impossibility of drug direct penetration via the membrane and contact with the mucous membrane. To increase the permeability of the tympanum, the authors used endaural phonophoresis of drugs. The drug penetration into the tympanum was confirmed by multispiral computed tomography (MSCT) of the temporal bones before and after contrasted ultraphonophoresis with tissue contrast. A 5% solution of potassium iodide was used as a contrast substance, as well as a solution of dexamethasone, which served as an intermediate medium in patients with external otitis and a chronic secretory otitis media. The mechanism of penetration was associated with the primary accumulation of the drug in the layers of the tympanic and adjacent mucous membranes with further dissemination into the deeper parts of the tympanic cavity. An additional confirmation of this is the reaction of the mucous membrane of the tympanic cavity, the mastoid process and the airiness restoration during endaural phonophoresis with dexamethasone. Ultraphonophoresis of drugs through the imperforated eardrum can be used in the conservative treatment of protracted forms of secretory otitis media.