Otolaryngologists are taught as residents to aspirate middle ear effusions (MEE) during tympanostomy procedures. However, what are the arguments for doing this and is it necessary? When performing a tympanostomy procedure, otolaryngologists make an incision in the tympanic membrane (TM) and aspirate the middle ear space to remove MEE prior to placing a tympanostomy tube. Aspiration of MEE is easy to perform, especially if the patient is under general anesthesia (GA). But does aspiration of effusion help the patient? Is there additional risk of tube-related complications if aspiration does not occur?