Post-Procedural Care After Intratympanic Steroid Injection
After intratympanic steroid injection, you should remain in the otologic position (affected ear up) for 15-30 minutes to maximize medication absorption, and there are no specific dietary restrictions or required fasting periods. 1
Immediate Post-Injection Protocol
Positioning Requirements
- Keep your head tilted with the affected ear facing upward for 15-30 minutes after injection to allow the steroid solution to remain in contact with the round window membrane for optimal absorption 1
- This positioning is the single most important post-procedural instruction 1
What You Experienced: Swallowing and Neck Movement
- The steroid draining into your throat or nose when you swallowed or flexed your neck is a common occurrence and does not significantly compromise treatment efficacy 1
- The middle ear connects to the throat via the Eustachian tube, so some drainage is expected 1
- While maintaining position is ideal, the medication that reached the round window during the initial 15-30 minutes is what matters most for therapeutic effect 1
Dietary and Activity Restrictions
Eating and Drinking
- There is no required fasting period after intratympanic steroid injection 1
- You may eat and drink immediately after the procedure once the positioning time is complete 1
- The concern is not about food intake affecting the medication, but rather about maintaining the proper head position during the critical absorption window 1
Pain Management
- The pain you experienced during injection is related to mechanical trauma from needle insertion and pressure changes in the middle ear 2, 3
- Over-the-counter pain relievers can be used as needed after the procedure 3
Monitoring and Follow-Up
Tympanic Membrane Healing
- The injection site typically heals within 18 days (median), with most perforations closing spontaneously 4
- Persistent perforation (lasting >90 days) occurs in only 1.6% of cases 4
- Your provider should inspect the tympanic membrane at completion of the treatment course and at a delayed interval to ensure healing 1
Audiometric Monitoring
- Audiograms should be performed at completion of the treatment course and at delayed intervals 1
- If you're receiving multiple injections, interval audiograms between injections may help determine if hearing has recovered, potentially allowing early termination of therapy 1
Common Post-Injection Symptoms (What to Expect)
Expected Transient Effects
- Transient dizziness or vertigo can occur, particularly if the injection was in the posterior quadrants of the eardrum 3
- Tongue numbness may occur if the injection was in certain locations 3
- Mild pain at the injection site is common 3
- These symptoms typically resolve within hours to days 3
When to Contact Your Provider
- Persistent or worsening vertigo beyond 24 hours 3
- Signs of infection (increasing pain, fever, drainage) 2
- Persistent perforation that doesn't heal after several weeks 4
Optimizing Treatment Success
Timing Between Injections
- If you're receiving multiple injections, daily intervals may provide better hearing recovery than longer intervals (every 4 days) 5
- The typical protocol involves up to 4 injections over a 2-week period 1
Special Considerations
- If you have diabetes, intratympanic steroids rarely cause changes in serum glucose levels, unlike oral steroids 1
- The risk of systemic side effects is minimal compared to oral steroid therapy 1
Practical Tips for Future Injections
- Don't worry excessively about swallowing or minor neck movements during the procedure - while maintaining position is ideal, some drainage is inevitable and doesn't negate the treatment 1
- Using gauze to catch saliva (as you did) is reasonable, but the key is the initial 15-30 minute positioning period after injection 1
- Communicate with your provider about pain management options before the next injection if the discomfort was significant 3