The injections are performed with the patient lying down and using the office microscope. The ear is first cleaned of wax. A small area of the eardrum is numbed with a drop of medication. A small needle and syringe are then used and the needle is passed through the eardrum at the site that is numbed so that the tip is in the ear, near the round window. This is a membrane where drugs are absorbed in to the cochlea. The fluid is injected in to the middle ear and the patient stays lying down for 20-30 minutes during which he does not swallow or sniff. The drug sits against the round window and is absorbed in to the inner ear. The patient then sits up slowly and leaves the office. Patients should not drive for a few hours after this procedure. Water is kept out of the ear until it is confirmed that the tiny hole has healed.
Depending on timing, intra-tympanic steroid injection is also offered (dexamethasone 10-24mg/cc). Intra-typmpanic steroid injection is performed by inserting a needle through the eardrum and injecting about of highly concentrated steroids directly into the middle ear space. The patient is than instructed to keep the affected ear up for 30 minutes without swallowing, yawning, or popping the ear. After injection, the patient is allowed to immediately resume normal activities. This steroid injection has also been used to treat Meniere's Disease flare-ups.