Effectiveness of laser-assisted myringotomy for otitis media in children.
OBJECTIVE
To evaluate the effectiveness of OtoScan CO2 laser-assisted myringotomy (OtoLAM ESC/Sharplan) for acute otitis media and chronic otitis media with effusion (COME) in children.


METHODS
Retrospective review of 47 children with refractory acute otitis media (RAOM) or COME more than 3 months in duration in a pediatric otolaryngology practice.


METHODS
Laser-assisted myringotomy was performed on 47 patients (79 ears) using the OtoLAM device. There were 28 children (ages 0.50-3 years) with RAOM and 19 children (ages 0.58-15 years) with COME.


RESULTS
A total of 57.4% of procedures were considered treatment failures. Failures occurred in 53.6% of patients with RAOM on average +/-SD 3.89 +/- 2.16 weeks after the procedure and in 63.2% of patients with COME on average +/-SD 7.25 +/- 5.57 weeks after the procedure. Age, sex, microorganism isolated, myringotomy size, wattage, and laterality did not predict outcome. Ventilation tube insertion was performed in 27 (57.4%) patients. Two patients have persistent tympanic membrane perforations at 2 years.


CONCLUSIONS
Laser-assisted myringotomy in children with RAOM and COME was associated with a high incidence of recurrence or persistence of disease and with perforation of the tympanic membrane. Recommendations for use of the OtoLAM should include discussion of high failure rates and the strong likelihood of subsequent ventilation tube insertion. The OtoLAM remains an option for office-based ventilation of the middle ear for families and patients where general anesthesia is a concern.
Cotter
Cheryl S
CS
Division of Pediatric Otolaryngology, Nemours Children's Clinic, Orlando, Florida 32806, USA.
Kosko
James R
JR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods*; D010033:Otitis Media / Q000601:surgery*; D010034:Otitis Media with Effusion / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery