Search

The majority of children will develop an ear infection at some point in their lives, but the majority will be self-limiting or respond promptly to antibiotic treatment. Once ear discharge develops and fails to settle following treatment, continuing discharge may represent underlying pathology of the tympanic membrane such as a perforation or indicate the need for modification of the initial antibiotic treatment. In cases of chronic ear discharge it is vitally important that the ear drum can be seen clearly in order not to miss pathology such as cholesteatoma. Referral to an ear nose and throat specialist is indicated in cases where the ear discharge continues for a number of weeks or becomes recurrent.

Objective In the English speaking literature there is very little evidence demonstrating safe and effective tympanomastoid day case surgery in pediatric practice. At a time when there is ongoing pressure for trusts to meet financial government targets and our care provision revolves around a patient centred approach, could otolaryngologists perform more pediatric middle ear surgery on a day case basis? We report our experience with a series of 52 pediatric middle ear day cases. Method Prospective study from a London tertiary referral centre of 52 consecutive children undergoing tympanomastoid surgery. There were 6 categories of surgical procedure, ranging from myringoplasty to cochlear implantation. Post-operative recovery was monitored. The duration of anaesthesia was compared with the length of post-operative ward stay. Results The correlation co-efficient r = −0.2203, showing that there was no association between length of anaesthetic and duration of post-operative ward stay. Conclusions Despite minor post-operative problems including pain, bleeding, and nausea and vomiting all patients in this series were discharged on the day of surgery. For tympanoplasty our series adds weight to already available evidence. It is the first series showing that mastoid surgery, whether combined approach, traditional mastoidectomy or cochlear implantation can be performed safely as day cases in a pediatric population.