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Cohen D, Shechter Y, Slatkine M, Gatt N, Perez R. Laser Myringotomy in Different Age Groups. Arch Otolaryngol Head Neck Surg. 2001;127(3):260–264. doi:10.1001/archotol.127.3.260
To study the qualities of laser myringotomy (LM) as a treatment for middle ear ventilation problems.
Prospective study and follow-up of consecutive cases of adults, children, and infants. Patients were observed for up to 2 years.
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.
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.
Myringotomy was performed using new laser equipment, enabling a 0.1-second ablation with changeable diameter.
Close follow-up, with microscopic examination of all ears. Findings were noted on the medical charts.
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.
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.
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