Tubes Under Local Anesthesia for Ear Infections

One year old Madelyn was suffering from chronic ear infections. Her parents Annie and Scott had horrible experiences when their other kids had ear tubes. Annie learned about a new breakthrough called TULA – tubes under local anesthesia. TULA is a much less invasive procedure than traditional ear tubes. Dr. Demetrio Aguila is one of only a few surgeons worldwide offering TULA and in a stroke of good luck, he was in her home state of Nebraska.

Annie and Scott took one year old Madelyn to see Dr. Aguila because of her chronic ear infections.

Dr. Aguila is one of only a handful of surgeons in the country offering TULA – tubes under local anesthesia.

Annie learned about this exciting new technology through her profession.

Annie: I am a speech language pathologist at a school. When I learned about TULA I thought it sounded super cool. I did not think we would have the TULA option in Nebraska. I thought it was a coastal thing. We were so excited when we found out it was offered in our home state.

Dr. Aguila: Our practice is all about finding better ways to do everything. Our practice is known for being unconventional and TULA is a perfect fit for our philosophy here.

Annie and Scott had had problems when their other kids had ear tubes the traditional way – in the hospital, under general anesthesia and away from mom and dad.

Annie: Our oldest son he had tubes and then our third child had repeat tubes and so for him the first ones did not take well and so we had to go back and redo them within a few months which was kind of discouraging.

TULA with Dr. Aguila was a much better experience on every level.

Annie: We were with her every step of the way and she was with mom and dad which is great that we did not have to separate and did not have to stand behind the door as the nurse takes them away and they are confused about what is going on.

Two months after TULA Madelyn is a different child.

Annie: No fevers we are not having issues with antibiotics we are at daycare we are at work we are having sleeping so she’s sleeping through the night that’s probably the biggest difference she’s sleeping so well she’s happier she can hear, all good things.

Annie is spreading the word about TULA to everyone she knows.

Annie: There’s a great place in Norfolk, Nebraska called the Healing Hands that you should totally call and check to see what they can do for you. I love being able to tell my colleagues that this is an option for students in the public schools that they serve that this is an awesome consideration that they should consider and let them know about.

We are just grateful that this could go the way it did and that she is able to have that relief.

Contact Dr. Aguila Facebook:… Website:

First Surgery at Millard Family Hospital

Dr. Demetrio Aguila shares his excitement in performing the first surgery at Millard Family Hospital, a neighborhood hospital in Omaha, Nebraska fully equipped for surgery. Dr. AGuila was inspired by their mission of making healthcare accessible, personal and transparent.

Notalgia Paresthetica Explained

Notalgia paresthetica is a peripheral nerve problem resulting in intense and sometimes painful itching in the mid to upper back and between the shoulder blades. Dr. Demetrio Aguila has a simple way to diagnose and effectively treat Notalgia Paresthetica. In this video he explains how.

Dr. Demetrio Aguila MD explains.

“Notalgia Paresthetica is a problem that occurs in the back. Patients will say I have got itching or a burning sensation. Sometimes they will say I have a stabbing sensation or sometimes they will say I have an aching sensation or electrical sensation. Other patients will come in and just say it hurts doc, can you please take away the pain.

The pain arises from some small sensory nerves that come out of the spinal cord. They branch off from the spinal nerves and they go to the skin and the muscle in that area the patient describes the exact spot right between the shoulder blades where they are having the pain sometimes above that level. sometimes below and then I am pretty sure I know what is going on.

In that case what we will do is a diagnostic block. We will inject that local anesthetic around the nerves that I think might be causing the patient’s

Pain. If we turn those nerves off and we turn off the pain and the patient say doc this feels great, I tell them well we can treat that.

There is a surgical procedure which is relatively straightforward in which we turn those nerves off permanently so that the patients do not end up with chronic pain.


Ear Tubes Under Local Anesthesia

Dr. Aguila is one of a few surgeons in the U.S. now offering TULA, tubes under local anesthesia. In this video he demonstrates how the procedure works in the doctor’s office without the cost or inconvenience of a hospital or general anesthesia. TULA is a simple, affordable and accessible option for kids and adults who need ear tubes as a result of frequent ear infections.

Dr. Demetrio Aguila demonstrates in this video:

We are going to show you exactly how TULA works with this little model patient that we have here now

The procedure is simple. This is the device that

we used to put the tube in. This has a tube in it right now.

I am going to show you how that works.

Normally I have magnification loops on which allow me to see a higher magnification.

I look in there after the child has had his or her ears appropriately anesthetized. They are made nice and numb I put the device in here like this and I press the button boom tube’s in that’s, it all done!

This training model has in it a simulated eardrum and there you can see the tube right in the simulated eardrum. TULA is simple, easy, convenient, affordable

and accessible.

What more can you ask for?

Carpal Tunnel Release with Ultrasound Guidance Improves Sleep

Carpal Tunnel Release with Ultrasound Guidance is an exciting option for patients with Carpal Tunnel Syndrome. The procedure is done in a doctor’s office instead of the hospital and the downtime is far less than traditional open surgery. As one of a handful of surgeons in the U.S. offering this procedure Dr. Demetrio Aguila finds another major advantage for patients involving their sleep. Take a listen and see if you are a candidate –…

TULA: Tubes Under Local Anesthesia – Briley’s Story

Briley suffered from ear infections since she was six month old. Luckily for her Dr. Demetrio Aguila traveled to her hometown in Atkinson, Nebraska to offer her a cutting edge procedure called TULA – tubes under local anesthesia. Dr. Aguila has performed two of the first four TULA procedures done in the United States.

Briley in and out in less than an hour and on to her new life…

Learn more

Quick Recovery for Carpal Tunnel Syndrome


Michelle was putting off surgery for Carpal Tunnel Syndrome in hopes something would come along so she would not have to deal with the downtime of traditional surgery.
One day scrolling through Facebook she found her answer.
See if you are a candidate and chat with Dr. Aguila


Dr. Aguila Explains Meralgia Paresthetica


Meralgia Paresthetica is one of the most common nerve compression problems that Dr. Demetrio Aguila treats. The patient presents with thigh pain and or tingling that can travel down to the knee. The good news is that Dr. Aguila can essentially cure Meralgia Paresthetica with a simple, outpatient procedure. Learn more by watching this short video.

Carpal Tunnel Release With Ultrasound Guidance

Kathy and Barry drove three hours from their home in Casey, Iowa to undergo Carpal Tunnel Release under Ultrasound Guidance with Dr. Demetrio Aguila. Back for their one-month follow up appointment husband and wife are thrilled with the results. Both went back to work right away and Kathy says she has more energy than she’s had in ten years. Take a listen…

See if you are a candidate and chat with Dr. Aguila

Read about other patients who have had success with this procedure –

Ear Tubes Under Local Anesthesia

Dr. Demetrio Aguila is the first surgeon in the world to perform TULA – Tubes under local anesthesia. A child can sit on his or her mom’s lap while Dr. Aguila inserts the ear tubes under local anesthesia and in his office. TULA is safer, more convenient and cheaper than traditional ear tube surgery. Patients can save money and time while eliminating the risk of general anesthesia.

The Tula System has been demonstrated to be safe and effective in clinical studies, and 95% of parents in the most recent study were very satisfied with the Tula procedure.2,3 In a clinical study without sedation or general anesthesia, ENT doctors were able to successfully insert tubes in 87% of the children.2 If the in-office procedure is not successful or cannot be completed, your ENT doctor may reschedule the procedure in the OR.

Learn more at