This led out of the ear canal to a small pump that was carried in a pocket and supplied a slow flow of medication over a period of days. However, placement of the catheter required a hospital operation, and it was awkward to walk around with a tube hanging out the ear for weeks or more. The Silverstein MicroWick , developed by Herbert Silverstein, MD, of Sarasota, Florida, is designed to solve all these problems. Under local anesthesia in the office, a minute tube and a highly absorbent wick are placed so as to extend through the eardrum to the round window. In some cases, some minor surgery must be done in the round window area to insure access by the medication.
Nothing is visible from the outside.
Then, patients simply place the appropriate medication into the ear with a dropper or other dispenser, according to directions from their physician. The medication first stops at the eardrum, then is readily absorbed by the wick and drawn inward to the round window, whence it is absorbed into the inner ear. It will require extensive studies to determine whether the Arenberg microCath or the Silverstein MicroWick is the more effective. I have used both devices for my patients and they appear to be about equally effective. However, for ease of insertion and daily use, the MicroWick is more convenient and better tolerated.