Laser myringotomy in different age groups

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, chi ldren, and infants. Patients were observed for up to 2 years. Setting: Children underwent IM, with or without adenoidectomy, under genera l anesthesia in the operating room. Adults and infants underwent IM under t opical 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 laste d a mean 22 days in adults, 17 days in children, and 11 days in infants. Pa tient 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 ca ses resolved after a single LM treatment. All infants with AOM recovered pr omptly 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 ii safe alternative to ventilation tubes in th ese patients. In AOM, it was used instead of antibiotics and gave prompt re lief from symptoms and cure of the AOM.