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Laser Myringotomy in Different Age Groups
David Cohen, MD;
Yossi Shechter, EE;
Michael Slatkine, PhD;
Netta Gatt, MD;
Ronen Perez, MD
Arch Otolaryngol Head Neck Surg. 2001;127:260-264.
Objective To study the qualities of laser myringotomy (LM) as a treatment for
middle ear ventilation problems.
Design Prospective study and follow-up of consecutive cases of adults, children,
and infants. Patients were observed for up to 2 years.
Setting Children underwent LM, with or without adenoidectomy, under general
anesthesia in the operating room. Adults and infants underwent LM under topical
anesthesia, as an outpatient procedure.
Patients All consecutive patients with either secretory otitis media (SOM) (adults
and children) or acute otitis media (AOM) (infants) who agreed to participate
were included without selection.
Intervention Myringotomy was performed using new laser equipment, enabling a 0.1-second
ablation with changeable diameter.
Outcome Measures Close follow-up, with microscopic examination of all ears. Findings
were noted on the medical charts.
Results Among all age groups, 136 ears were followed up. Perforation lasted
a mean 22 days in adults, 17 days in children, and 11 days in infants. Patient
age was found to be a significant determining factor for duration of perforation
(P = .002). Laser myringotomy in the anterior and
inferior areas lasted longer than posterior LM (P<.001).
In patients with SOM, during the time the LM was patent, all ears were ventilated.
In children, 38% of SOM cases resolved after a single LM treatment. All infants
with AOM recovered promptly without antibiotic treatment.
Conclusions Laser myringotomy is a convenient, quick procedure that can be performed
in the medical office with the use of topical anesthesia and is suitable for
patients with AOM or for those who need short-term ventilation for SOM. It
was found to be a safe alternative to ventilation tubes in these patients.
In AOM, it was used instead of antibiotics and gave prompt relief from symptoms
and cure of the AOM.
From the Department of Otolaryngology/Head and Neck Surgery, Shaare
Zedek Medical Center, Jerusalem, Israel (Drs Cohen, Gatt, and Perez); and
ESC/Sharplan, Tel Aviv, Israel (Mr Shechter and Dr Slatkine).
Corresponding author: David Cohen, MD, Department of Otolaryngology/Head
and Neck Surgery, Shaare Zedek Medical Center, PO Box 3235, Jerusalem, Israel
91031 (e-mail: yossis{at}escmed.com).
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ABSTRACT
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