Ventilation tube insertion using topical anaesthesia in children.

Topical anaesthesia using EMLA cream is an established anaesthetic technique for ventilation tube insertion in adults. We report its use in 103 children (age range 3-12 years). Failure occurred in seven patients (6.8 per cent); complications occurred in two patients and were of a minor nature. This technique appears well tolerated provided the operator avoids the use of suction and allows a cream penetration time of greater than two hours. The use of a 'T' myringotomy is also recommended, to reduce tension on the drum at tube insertion.