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Inner Ear Injections (Intratympanic Injections)

What are Inner Ear Injections?

Inner ear injections, also called intratympanic injections, are treatments where a specialist places medicine through the eardrum. The medicine then moves toward the inner ear.

These injections may help control vertigo attacks that are hard to manage, especially with Ménière’s disease. They may also be used for sudden sensorineural hearing loss, which is sudden hearing loss caused by a problem in the inner ear or hearing nerve.

The most common medicines used are steroids and gentamicin.

This is usually done in a clinic. The goal is to help reduce vertigo attacks or treat certain inner ear problems when other treatments have not helped enough.

Depiction of medicine being injected through the eardrum

What Conditions Are Inner Ear Injections Used For?

Inner ear injections may be used to treat:

  • Ménière’s disease, especially when vertigo attacks keep happening and other conservative treatment has not been effective
  • Sudden sensorineural hearing loss
  • Certain inner ear problems, based on your diagnosis

Your specialist will decide if this treatment is safe and helpful for you.

Who Gives Inner Ear Injections?

These injections are usually done by an ENT doctor. Some people see a specialist called a neurotologist or otologist. These doctors focus on ear and balance disorders. Learn more about these different types of clinicians.

Why Am I Having Inner Ear Injections?

You may be having inner ear injections to:

  • Help reduce vertigo attacks
  • Place medicine closer to the inner ear
  • Use steroids to reduce irritation or swelling
  • Use gentamicin to help control severe vertigo
  • Treat sudden hearing loss when fast care is important

Your treatment plan depends on your symptoms, test results, and diagnosis.

Are Inner Ear Injections Safe?

Inner ear injections are a treatment that does not require surgery. A small needle is used to place medicine through the eardrum and into the middle ear. Many people do well, but there are some risks.

Common short-term side effects may include:

  • Brief ear pain
  • Ear pressure or fullness
  • Temporary dizziness
  • Nausea
  • Ringing in the ear

Less common risks may include:

  • Ear infection
  • Ear drainage
  • A small hole in the eardrum that does not heal
  • Hearing changes

The risk can depend on the medicine used:

  • Steroid injection: lower risk of hearing loss
  • Gentamicin injection: may help severe vertigo but higher risk of hearing loss or longer-lasting balance problems

During treatment, you can always tell the provider how you feel and ask to:

  • Take a break
  • Stop if needed

Will Inner Ear Injections Help?

Many people have fewer or less severe vertigo attacks after treatment. Results are different for each person.

Some people need more than one injection. Others may also need diet changes, medication, or vestibular rehab.

It is also normal to have good days and bad days. Some people feel more dizzy for a short time after the injection. This usually improves, but you should tell your provider if dizziness feels severe or does not get better.

Before Your Appointment

Your provider may ask you to:

  • Eat a light meal before your visit
  • Avoid alcohol for 24 hours before treatment
  • Limit caffeine that day
  • Tell them about blood thinners, aspirin, and supplements
  • Tell them if you have an ear infection, ear tube, or recent ear surgery
  • Plan to rest after the appointment

Do not stop any medicine unless your provider tells you to.

What Should I Wear and Bring?

What to Wear

  • Comfortable clothes
  • Flat, stable shoes
  • Avoid large earrings or anything that blocks access to your ear
  • Wear your hair so your ear is easy to reach (clip/ponytail if needed)

What to Bring

  • Photo ID
  • Insurance card
  • List of your medicines and doses
  • Glasses or hearing aids (if you use them)
  • A small snack and water (helpful if you feel nauseated)

Should I Bring a Ride?

You may need a ride home.

Some treatments can:

  • Make you feel dizzy
  • Cause nausea for a short time
  • Make it unsafe to drive right after

Ask your provider ahead of time if you should plan for a ride.

Questions You May Want to Ask Your Provider

At your appointment it may be helpful to ask your provider the following questions so that you are prepared for the treatment and possible results of it. 

  • Which medicine will you use: steroid or gentamicin?
  • Why is this medicine the best choice for me?
  • How many injections will I need?
  • How far apart will the injections be?
  • What side effects should I expect?
  • What is the risk to my hearing or balance?
  • Do I need to keep my ear dry after treatment?
  • When should I expect results?
  • What should I do if I feel worse?
  • Will I need follow-up hearing or balance testing?
  • What are the next steps if this does not help?
  • Could vestibular rehab help me?

Also ask your clinician about any instructions or risks not listed here.

What Will Happen During Inner Ear Injections?

You may:

  • Have numbing medicine placed in or near the ear
  • Lie down with the treated ear facing up
  • Be asked to stay very still
  • Feel a quick pinch or pressure
  • Rest in the same position so the medicine can soak in
  • Be asked not to talk, chew, or swallow for a short time

The visit may take about 20 to 60 minutes, depending on the treatment.

What May I Feel During Treatment?

  • A quick pinch or pressure
  • Ear fullness
  • Popping or crackling sounds
  • Temporary dizziness or spinning
  • Nausea
  • Ringing in the ear
  • A strange taste in your mouth

These feelings are common and usually do not last long.

Tell your provider what you feel during the treatment.

How Will I Feel After An Inner Ear Injection?

Most people have:

  • Mild ear soreness
  • Ear pressure or fullness
  • Mild dizziness or imbalance
  • Mild nausea that improves with rest

Some people may have:

  • Stronger vertigo for a short time
  • Ear drainage
  • More ear pain
  • Hearing changes
  • Longer-lasting imbalance, especially after gentamicin

When Will I Feel Results?

Some people notice fewer vertigo attacks within days to weeks. Others need a series of injections before they notice a change.

If the injection is used for sudden hearing loss, your provider may repeat hearing tests over the next few weeks. Improvement may happen slowly. It may come in steps, not all at once.

What Should I Do After Treatment?

After treatment:

  • Rest for the day if needed
  • Sit or lie down if you feel dizzy
  • Do not drive until you feel safe
  • Follow instructions about keeping your ear dry
  • Ask when you can return to work, exercise, or normal activity

If you feel more unsteady after treatment, ask if vestibular rehab could help.

When To Call Your Provider

Call your provider if you have:

  • Severe dizziness that does not improve
  • Trouble walking safely
  • New or quickly worsening hearing loss
  • Severe ear pain
  • Ear swelling or redness
  • Fever
  • Pus-like drainage or a bad smell from the ear
  • Heavy bleeding from the ear

Call 911 if you have:

  • Severe headache
  • New weakness
  • New numbness
  • Trouble speaking
  • Stroke-like symptoms

Key Things to Remember

  • Inner ear injections place medicine through the eardrum.
  • The medicine can move toward the inner ear.
  • These injections are often used for Ménière’s disease.
  • They may also be used for sudden hearing loss.
  • Steroids usually have a low risk of hearing loss.
  • Gentamicin may help severe vertigo but can increase the risk of hearing or balance problems.
  • Temporary ear fullness, dizziness, or nausea can happen.
  • Ask ahead of time if you need a ride home.
  • Follow your provider’s after-care instructions.
  • Small improvements can still be important.

Additional Resources