• Severe acute otitis media
  • Poor response to antibiotic for otitis media 
  • Recurrent episodes of acute otitis media (more than 3 episodes in 6 months or more than 4 episodes in 12 months)
  • Otitis media with effusion > 3 months
  • Hearing loss > 30 dB in patient with otitis media with effusion
  • Craniofacial anomalies that predispose to middle ear dysfunction (e.g., cleft palate).
  • Impending mastoiditis or intra-cranial complication due to otitis media
  • Chronic retraction of tympanic membrane or pars flaccida 
  • Barotitis media control
  • Autophony due to patulous eustachian tube.
  • Middle ear dysfunction due to head and neck radiation and skull base surgery.

Physical Examination 

  • Description of tympanic membrane.

  • Description of middle ear space.

  • Audiometry (within 3 months of surgery) -pure tones and/or Speech Reception Thresholds.

  • Tympanometry.

Postoperative Observations requiring follow up

  • Persistent or profuse bleeding from ear

  • Otorrhea

Outcome Review 

First Month

  • Infection--Has there been any discharge from the ear requiring treatment?
  • Tube-- Check placement and patency of tube.

Beyond One Month

  • Hearing--Is hearing improved? (Document with audiogram)
  • Infection--Has there been a decrease in the number of ear infections?
  • Tube--Is tympanostomy tube functioning?
  • Continued follow-up every 3-6 months.