<unk>  is usually performed as an outpatient procedure. General anesthesia is preferred in children, while local anesthesia suffices for adults. The ear is washed and a small incision made in the eardrum. Any fluid that is present is then aspirated, the tube of choice inserted, and the ear packed with cotton to control any slight bleeding that might occur. This is known as conventional (or cold knife)<unk>  and usually heals in one to two days. A new variation (called tympanolaserostomy or laser-assisted tympanostomy) uses a CO2 laser, and is performed with a computer-driven laser and a video monitor to pinpoint a precise location for the hole. The laser takes one-tenth of a second to create the opening, without damaging surrounding skin or other structures. This perforation remains patent for several weeks and provides ventilation of the middle ear without the need for tube placement. Though laser<unk> es maintain patency slightly longer than cold-knife<unk> es (two to three weeks for laser and two to three days for cold knife without tube insertion), they have not proven to be more effective in the management of effusion. One randomized controlled study found that laser<unk> es are safe but less effective than ventilation tube in the treatment of chronic OME. Multiple occurrences in children, a strong history of allergies in children, the presence of thick mucoid effusions, and history of tympanostomy tube insertion in adults, make it likely that laser tympanostomy will be ineffective. Various tympanostomy tubes are available. Traditional metal tubes have been replaced by more popular silicon, titanium, polyethylene, gold, stainless steel, or fluoroplastic tubes. More recent ones are coated with antibiotics and phosphorylcholine.
Myringotomy
Tenotomy
Facial nerve decompression
Uvulopalatopharyngoplasty
Uvulopalatoplasty
Cricopharyngeal myotomy
Nymphotomy
Septoplasty