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Ventilation time of the middle ear in otitis media with effusion (OME) after CO2 laser myringotomy.
Laryngoscope 2002; 112(4):661-8L

Abstract

OBJECTIVE

The aim of this study was to investigate the transtympanic ventilation time, the healing course of the tympanic membrane, the early and late complications, and the recurrence rate of otitis media with effusion (OME) within 6 months after CO2 laser myringotomy with the CO2 laser otoscope Otoscan.

STUDY DESIGN

Prospective clinical study.

MATERIALS AND METHODS

In this study, laser myringotomy was performed with the CO2 laser otoscope Otoscan in a patient population comprising 81 children (159 ears) with a history of otitis media with effusion (OME) associated with adenoidal and sometimes tonsillar hyperplasia. The procedure on the tympanic membrane was accordingly combined with an adenoidectomy, a CO2 laser tonsillotomy, or a tonsillectomy and therefore performed under insufflation anesthesia. In all ears, approximately 2 mm circular perforations were created in the lower anterior quadrants with a power of 12 to 15 W, a pulse duration of 180 msec, and a scanned area of 2.2 mm in diameter.

RESULTS

None of the children showed postoperative impairment of cochleovestibular function such as sensorineural hearing loss or nystagmus. Otomicroscopic and videoendoscopic monitoring documented the closure time and healing pattern of tympanic membrane perforations. The mean closure time was found to be 16.35 days (minimum, 8 days; maximum, 34 days). As a rule, an onion-skin-like membrane of keratinized material was seen in the former myringotomy perforations at the time of closure. At the follow-up 6 months later, the condition of the tympanic membrane of 129 ears (81.1%) could be checked by otomicroscopy and videoendoscopy and the hearing ability by audiometry and tympanometry. The CO2 laser myringotomy sites appeared normal and irritation-free. Two of the tympanic membranes examined (1.6%) showed atrophic scar formation, and 1 (0.8%) had a perforation with a diameter of 0.3 mm. The perforation was seen closed in a control otoscopy 15 months postoperatively. OME recurred in 26.3% of the ears seen intraoperatively with mucous secretion (n = 38) and in 13.5% of the ears with serous secretion (n = 37; P <.05).

CONCLUSION

The most important principle in treating OME is ventilation of the tympanic cavity. CO2 laser myringotomy achieves this through a self-healing perforation in which its diameter roughly determines the duration of transtympanic ventilation. Laser myringotomy competes with ventilation tube insertion in the treatment of OME. It may be a useful alternative in the surgical management of secretory otitis media.

Authors+Show Affiliations

Ear, Nose and Throat Department, Medical Center Benjamin Franklin, Free University of Berlin, Germany. sedlhno@zedat.fu-berlin.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12150520

Citation

Sedlmaier, Benedikt, et al. "Ventilation Time of the Middle Ear in Otitis Media With Effusion (OME) After CO2 Laser Myringotomy." The Laryngoscope, vol. 112, no. 4, 2002, pp. 661-8.
Sedlmaier B, Jivanjee A, Gutzler R, et al. Ventilation time of the middle ear in otitis media with effusion (OME) after CO2 laser myringotomy. Laryngoscope. 2002;112(4):661-8.
Sedlmaier, B., Jivanjee, A., Gutzler, R., Huscher, D., & Jovanovic, S. (2002). Ventilation time of the middle ear in otitis media with effusion (OME) after CO2 laser myringotomy. The Laryngoscope, 112(4), pp. 661-8.
Sedlmaier B, et al. Ventilation Time of the Middle Ear in Otitis Media With Effusion (OME) After CO2 Laser Myringotomy. Laryngoscope. 2002;112(4):661-8. PubMed PMID: 12150520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ventilation time of the middle ear in otitis media with effusion (OME) after CO2 laser myringotomy. AU - Sedlmaier,Benedikt, AU - Jivanjee,Antonio, AU - Gutzler,Rico, AU - Huscher,Dörte, AU - Jovanovic,Sergije, PY - 2002/8/2/pubmed PY - 2002/8/17/medline PY - 2002/8/2/entrez SP - 661 EP - 8 JF - The Laryngoscope JO - Laryngoscope VL - 112 IS - 4 N2 - OBJECTIVE: The aim of this study was to investigate the transtympanic ventilation time, the healing course of the tympanic membrane, the early and late complications, and the recurrence rate of otitis media with effusion (OME) within 6 months after CO2 laser myringotomy with the CO2 laser otoscope Otoscan. STUDY DESIGN: Prospective clinical study. MATERIALS AND METHODS: In this study, laser myringotomy was performed with the CO2 laser otoscope Otoscan in a patient population comprising 81 children (159 ears) with a history of otitis media with effusion (OME) associated with adenoidal and sometimes tonsillar hyperplasia. The procedure on the tympanic membrane was accordingly combined with an adenoidectomy, a CO2 laser tonsillotomy, or a tonsillectomy and therefore performed under insufflation anesthesia. In all ears, approximately 2 mm circular perforations were created in the lower anterior quadrants with a power of 12 to 15 W, a pulse duration of 180 msec, and a scanned area of 2.2 mm in diameter. RESULTS: None of the children showed postoperative impairment of cochleovestibular function such as sensorineural hearing loss or nystagmus. Otomicroscopic and videoendoscopic monitoring documented the closure time and healing pattern of tympanic membrane perforations. The mean closure time was found to be 16.35 days (minimum, 8 days; maximum, 34 days). As a rule, an onion-skin-like membrane of keratinized material was seen in the former myringotomy perforations at the time of closure. At the follow-up 6 months later, the condition of the tympanic membrane of 129 ears (81.1%) could be checked by otomicroscopy and videoendoscopy and the hearing ability by audiometry and tympanometry. The CO2 laser myringotomy sites appeared normal and irritation-free. Two of the tympanic membranes examined (1.6%) showed atrophic scar formation, and 1 (0.8%) had a perforation with a diameter of 0.3 mm. The perforation was seen closed in a control otoscopy 15 months postoperatively. OME recurred in 26.3% of the ears seen intraoperatively with mucous secretion (n = 38) and in 13.5% of the ears with serous secretion (n = 37; P <.05). CONCLUSION: The most important principle in treating OME is ventilation of the tympanic cavity. CO2 laser myringotomy achieves this through a self-healing perforation in which its diameter roughly determines the duration of transtympanic ventilation. Laser myringotomy competes with ventilation tube insertion in the treatment of OME. It may be a useful alternative in the surgical management of secretory otitis media. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/12150520/Ventilation_time_of_the_middle_ear_in_otitis_media_with_effusion__OME__after_CO2_laser_myringotomy_ L2 - https://doi.org/10.1097/00005537-200204000-00013 DB - PRIME DP - Unbound Medicine ER -