Adenoidectomy with laser or incisional myringotomy for otitis media with effusion

Objective: To compare the effectiveness of CO2 laser myringotomy to incisio nal myringotomy at the time of adenoidectomy for refractory otitis media wi th effusion (OME). Study Design: Controlled retrospective consecutive case series, Methods: All children undergoing myringotomy and adenoidectomy for OME in the spring of 1999 had 1.7-mm-diameter perforations created in their tympanic membranes using a CO2 laser and conventional microslad. Their ear s were evaluated at first postoperative visit (mean, 16.65 days after surge ry) by a validated otoscopist to determine the presence or absence of perfo rations and middle ear effusions. These patients were compared with histori cal controls comprising all children undergoing incisional myringotomy and adenoidectomy in 1998. A chi(2) analysis was performed to compare the resul ts of these two myringotomy techniques, Results: Twenty-three children (39 ears) underwent laser myringotomy and adenoidectomy in 1999, compared with 26 children (48 ears) who underwent incisional myringotomy and adenoidectom y in 1998, In the laser myringotomy group, 8 of the 39 ears had a persisten t opening at first follow-up; 4 of the 39 ears showed evidence of effusion, In the incisional myringotomy group, all 48 ears had healed ? of these ear s showed evidence of effusion. Conclusion: Myringotomies created using the CO2 laser are more likely to be patent at first postoperative visit than th ose made with incisional technique (P <.01). However, this prolonged middle ear ventilation does not significantly decrease the prevalence of effusion (P >.1).