Diode laser myringotomy for short-term middle-ear ventilation: a pilot study on children

Abstract

EnAbstract Objective The aim of the study was to evaluate diode laser myringotomy (DLM) in children for the management of Eustachian tube and middle-ear disorders that require myringotomy for short-term treatment. Study design This is a prospective clinical study. Patients and methods The study comprised 20 children selected to undergo DLM for middle-ear ventilation as a mode of treatment for recurrent acute serous otitis media; these children suffered from persistent middle-ear effusion and had experienced failure of medical treatment for at least 8 weeks. Postoperative weekly visits to evaluate the myringotomy opening (MO) were carried out until healing was recorded. The Eustachian tube and hearing ability were evaluated preoperatively and postoperatively 4 weeks after healing of the tympanic membrane. Cases were deemed to be failed when the MO closed early within the second week postoperatively without improvement in hearing, or the myringotomy persisted until the end of the third month postoperatively. Outcome measures were the state of the MO and of the ear drum, the patency time of the myringotomy, improvement in hearing and Eustachian tube function and incidence of operative and postoperative complications. Results The mean operative time was 5 min. No operative complications occurred. Procedural success was achieved in 16/20 ears (80%). Two ears showed postoperative persistent perforations, and two recorded early closure of the MO. The mean improvement in the air/bone gap was 12 dB for the successful cases. Twelve ears with healed MOs showed type A curve (75%). Four ears showed type C curve (25%) and needed further management. Conclusion DLM is useful in children for the management of Eustachian tube and middle-ear disorders needing myringotomy for short-term treatment.