The placement of tubes is not a cure. If middle ear disease has been severe or prolonged enough to justify tube placement, there is a strong possibility that the child will continue to have episodes of middle ear inflammation or fluid collection. There may be early drainage through the tube (tube otorrhea) in about 15% of patients in the first two weeks after placement, and developing in 25% more than three months after insertion, although usually not a longterm problem. Otorrhea is considered to be secondary to bacterial colonization. The most commonly isolated organism is Pseudomonas aeruginosa, while the most troublesome is Methicillin-resistant Staphylococcus aureus (MRSA). Some practitioners use topical antibiotic drops in the postoperative period, but research shows that this practice does not eradicate the bacterial biofilm. A laboratory study showed that tubes covered in the antibiotic vancomycin prevented in-vitro formation of MRSA biofilm as compared to noncoated ones, although no study has been conducted on humans yet. Comparing phosphorylcholine-coated fluoroplastic tympanostomy tubes to uncoated fluoroplastic tympanostomy tubes showed no statistically significant difference in the incidence of post-operative otorrhea, tube blockage, or extrusion.
Myringotomy
Tenotomy
Facial nerve decompression
Uvulopalatopharyngoplasty
Uvulopalatoplasty
Cricopharyngeal myotomy
Nymphotomy
Septoplasty