Laser-assisted myringotomy versus conventional myringotomy with ventilation tube insertion in treatment of otitis media with effusion: Long-term follow-up

Abstract

Background

Otitis media with effusion is the most common cause of conductive hearing loss in the pediatric population. Insertion of ventilation tubes with or without adenoidectomy is the accepted and standard surgical procedure. CO ₂ laser myringotomy without tube placement has been advocated as an alternative treatment.

Aim

To compare long-term follow-up results of laser versus classical myringotomy with ventilation tube insertion over five years.

Materials and Methods

86 patients with bilateral otitis media with effusion were divided into two groups: laser myringotomy group and myringotomy with ventilation tube insertion group, with follow-up in hearing results and recurrence rates over five years.

Results

The mean patency time of myringotomy in laser group was 23 days, while the mean patency time of the ventilation tubes ears was 4.0 months in myringotomy group. Twelve patients in laser group (13.9%) showed a recurrent otitis media with effusion compared to 9 patients in myringotomy group (10.4%).

Conclusion

Laser fenestration is a less effective alternative to myringotomy and tube placement. The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation.