In-office myringotomy and tympanostomy tube insertion

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We describe the nuances of performing in-office microscopic and endoscopic myringotomy and tympanostomy tube placement for the treatment of otitis media and Eustachian tube dysfunction. With the advent of new high-definition video technology, the endoscope has been safely applied to the clinic setting and is non–inferior to the standard microscopic approach. In this article, we will outline the indications, patient selection, approach selection, topical anesthetic options, procedural details, complications, and challenges of in-office myringotomy and tympanostomy tube placement.