Adenoidectomy with laser or incisional myringotomy for otitis media with effusion.
OBJECTIVE
To compare the effectiveness of CO2 laser myringotomy to incisional myringotomy at the time of adenoidectomy for refractory otitis media with effusion (OME).


METHODS
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 ears were evaluated at first postoperative visit (mean, 16.65 days after surgery) by a validated otoscopist to determine the presence or absence of perforations and middle ear effusions. These patients were compared with historical controls comprising all children undergoing incisional myringotomy and adenoidectomy in 1998. A chi2 analysis was performed to compare the results 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 adenoidectomy in 1998. In the laser myringotomy group, 8 of the 39 ears had a persistent opening at first follow-up; 4 of the 39 ears showed evidence of effusion. In the incisional myringotomy group, all 48 ears had healed; 7 of these ears showed evidence of effusion.


CONCLUSIONS
Myringotomies created using the CO2 laser are more likely to be patent at first postoperative visit than those made with incisional technique (P < .01). However, this prolonged middle ear ventilation does not significantly decrease the prevalence of effusion (P > .1).
Szeremeta
W
W
Department of Otorhinolaryngology and Bronchoesophagology, Temple University School of Medicine, and the Temple University Children's Medical Center, Philadelphia, Pennsylvania 19140, USA.
Parameswaran
M S
MS
Isaacson
G
G
D000233:Adenoidectomy / Q000295:instrumentation / Q000379:methods; D002245:Carbon Dioxide; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003475:Curettage; D004564:Electrocoagulation; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D010034:Otitis Media with Effusion / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013396:Suction; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*; D014945:Wound Healing
D002245:Carbon Dioxide