SHORT-TERM TYMPANOSTOMY IN CONJUNCTION WITH HYPERBARIC-OXYGEN THERAPY

Objective: To determine the most effective method of short-term middle ear aeration in patients unable to tolerate hyperbaric oxygen (HBO) t herapy. Study Design: Prospective study comparing two methods of short -term tympanostomy in each patient. Methods: Seventeen adult patients were referred for management of barotitis and inability to tolerate hy perbaric oxygen therapy (HBO), Each patient underwent CO2 laser tympan ostomy on the right ear and tympanostomy with T-tube placement in the left ear. The tube was removed on completion of HBO, Patients were ask ed to rate pain and their satisfaction with each method of tympanostom y using a visual analog scale. Otorrhea, persistent perforation, recur rent barotitis, hearing loss, and otalgia occurring during the study p eriod were documented, Results: Laser tympanostomy was associated with a significantly lower incidence of otorrhea but was attended by re cu rrent barotitis in four of 16 patients. Laser tympanostomy was perceiv ed as being less painful and was rated higher in overall satisfaction. Conclusions: Laser tympanostomy is an effective method for management of barotitis in patients unable to tolerate HBO, Otorrhea is signific antly reduced, although a risk of recurrent barotitis exists if the la ser perforation closes prior to completion of HBO, Both methods of sho rt-term tympanostomy reduce complications when compared with a retrosp ective cohort.