The anesthetic risks during placement of tympanotomy tubes were prospectively studied in 510 children. Complications were analyzed according to patient risk factors, anesthesia regimen, and surgical variables. No complications were seen in 423 (82.9%) children. Minor degrees of upper airway obstruction (treated with jaw thrust, oral airway, or positive pressure ventilation) were encountered in 61 patients (12.0%), 1 patient had minor obstruction and bradycardia, and 7 patients (1.4%) experienced more severe airway obstruction. Vomiting occurred intraoperatively in 2 patients (0.4%) and postoperatively in 9 patients (1.8%). Twelve patients (2.4%) experienced other complications, including cardiac dysrhythmias, transient hyperthermia, fall from the transport stretcher, and transient agitation. Four patients experienced multiple complications. Patient age, history of anesthesia, and level of experience of the anesthetist were all related to the type and frequency of complications. Anesthesia given for placement of ventilation tubes into tympanic membranes is relatively safe; however, these data are applicable to patients treated by pediatric anesthesiologists in the setting of a children's hospital.

Pneumoparotitis is a rare cause of parotid inflammatory disease in both adults and children. A 12-year-old girl is reported who presented with recurrent bilateral parotid swelling. Radiologic evaluation revealed pneumoparotitis associated with masseter muscle hypertrophy. Further investigation revealed the self-induced nature of the condition in this teenager. Self-induced pneumoparotitis has been reported almost exclusively in adolescents who often have psychosocial problems. The clinical presentation, proposed pathophysiology, diagnosis and management of this rare condition are discussed and a review of the literature is presented.