Tympanostomy tube (TT) placement in children for the treatment of chronic otitis media with effusion (COME) and recurrent acute otitis media (RAOM) is the most common surgical procedure performed among otolaryngologists. Despite its popular-ity, the literature is lacking in information for family doctors regarding many aspects of the procedure, including indications, complications, and post-operative patient care. In this review, we discuss COME, RAOM, rationale and indications for TT placement and complications of TT placement. With respect to the complications of TT placement there will be an emphasis on management of post-operative otorrhea, and post-operative patient care.

Last year the Bulletin (June 1984, 8, 112-114) pub lished a statement on hospital closures and community care from the National Schizophrenia Fellowship which was widely circulated to influential bodies. This statement was sent to the Minister for Health, Mr Kenneth Clarke, and on 29 May 1984, he replied to the NSF. The NSF wrote back to Mr Clarke on 2 July, to which he again responded in a letter of 2 October. These three letters are published below and it is hoped that they will be of interest to our readership.

Following the publication of correspondence between the then Minister for Health, Mr Kenneth Clarke, and the National Schizophrenia Fellowship (Bulletin, March 1985, 9, 49–55), we are now publishing the concluding letters in this exchange of correspondence. (Mrs Joyce Major has been succeeded by Mr R. N. Lines as Chairman of the NSF.)We use the expression ‘long-term patient’ to describe one who, whether in hospital or elsewhere, needs a great deal of supervision and/or nursing care. We use ‘long-stay patient’ for the smaller category in hospital or equivalent health service institution. The great majority of long-term who are not long-stay are at present cared for by relatives, if at all; a small fraction are in staffed homes provided by the voluntary sector, or are in local authority hostels.