Minimally invasive laser contraction myringoplasty for tympanic membrane atelectasis.
OBJECTIVE
We sought to develop a minimally invasive surgical technique using the CO(2) laser to reduce or eliminate tympanic membrane atelectasis in a select group of patients.


METHODS
Thirty-seven ears with varying degrees of tympanic membrane atelectasis underwent CO(2) laser myringoplasty with the patients under intravenous sedation in the operating room setting. Atelectasis severity was graded for each patient and documented before and after laser myringoplasty through photodocumentation. Patients were followed for 1 year with comparison tympanic membrane photography.


METHODS
The study was conducted in a tertiary care private otology-neurotology practice.


RESULTS
Laser myringoplasty significantly reduced retraction pocket severity in most patients. No patients required resection of the retraction pocket or tympanoplasty. The most favorable outcomes were observed in patients with atelectasis addressed early rather than later in its more advanced stages.


CONCLUSIONS
Laser contraction myringoplasty can reduce or eliminate atelectatic areas of the tympanic membrane through immediate contraction and "tightening" of the tympanic membrane tissues. Clinicians should use a standardized tympanic membrane atelectasis grading format.


CONCLUSIONS
A minimally invasive surgical technique for addressing tympanic membrane atelectasis is described, and a tympanic membrane atelectasis grading system is presented based on size, location, and depth of the atelectatic region.
Ostrowski
Vincent B
VB
Michigan Ear Institute, Farmington Hills, Michigan 48334, USA.
Bojrab
Dennis I
DI
D000293:Adolescent; D000328:Adult; D002245:Carbon Dioxide / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004427:Ear Diseases / Q000145:classification / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009225:Myringoplasty / Q000379:methods*; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*
D002245:Carbon Dioxide