Endoscopic tympanic neurectomy for otic neuralgia: a case series

Otic neuralgia (ON) is a diagnostic and therapeutic challenge. ON is often attributed to either direct or referred pain from other structures. The tympanic nerve is the major contributor to sensory supply of the middle ear mucosa. A tympanic neurectomy has previously been described for the management of ON with promising results. This work aims to describe an endoscopic approach to the tympanic neurectomy and assess results in a case series of 8 patients. A multi-center retrospective review was conducted searching for cases of endoscopic tympanic neurectomies performed for ON; the sites included Royal North Shore Hospital; Sydney, Macquarie University Hospital, Sydney and the Victoria General Hospital, Dalhousie University, Halifax. From May 2014 to December 2016 there were a total of eight endoscopic tympanic neurectomies performed for ON. The mean age at presentation was 46.4 years (range, 29-75 years), there were 7 females and 1 male. All patients were pain free after an average of 2.1 months (range, immediate relief to 5 months) with one case of recurrent ON noted that resolved after further treatment. Tympanic neurectomy offers a therapeutic option for ON once alternative causes have been excluded. The endoscope allows improved visualization allowing for a more precise and complete neurectomy.