Otitis media with effusion (OME) is the most common cause of hearing loss in children and ventilation tubes (VT) is accepted as a standard surgical treatment, which is the most common operation in young children requiring multiple general anesthesia (GA). Laser myringotomy (LM) was introduced as an option for office-based ventilation under topical anaesthesia (TA) to avoid the concerns of families who refuse VT and GA. The efficacy of LM without VT was reported to be 40% resulting in frequent failures, which is roughly between that of knife myringotomy (KM) and VT insertion. LM-assisted VT insertion overcame the frequent LM failure and reduced GA, but the limited feasibility of LM-assisted VT in young children requires the integration of two procedures. In our clinic, these children have been allocated to “flexible integration of laser tympanostomy and ventilation tube insertion under topical anaesthesia” (FITT) procedure. FITT is 1) To stop antibiotic overuse 2) To restore normal hearing promptly with VT insertion 3) To assess the outcome of VT: duration until extrusion, otorrhea and 4) To decide the need for long-term treatment such as adenoidectomy or long-term tube. We have reported that LM-assisted VT insertion was feasible in 73% for one VT, and 45% for both VT, which could reduce 80% of required GA. Tympanostomy tube otorrhea (TTO) may occur immediately after tube insertion from an existing infection in the middle ear or later, with subsequent middle-ear infections or infectious processes in the ear canal. Treatment of TTO has favored the topical therapy in the form of eardrops with or without systemic antibiotic therapy.