Aspiration of middle ear fluid after myringotomy is performed routinely, although investigators imply a cause-and-effect relationship between suction noise and acoustic trauma. This prospective randomized study investigated if aspiration was necessary. Fifty-one myringotomies and 50 tympanostomy tube insertions were performed on 27 patients. A suction instrument was utilized in 24 ears and was not used in 27 ears. In a follow-up period, no difference was observed between the two groups. The authors did not establish that aspiration is indeed harmful, but tympanostomy tube insertion can be performed without suctioning middle ear effusion.