Efficacy of the KTP laser in the treatment of middle ear cholesteatoma.
OBJECTIVE
To evaluate whether ancillary use of the KTP (potassium titanyl phosphate) laser can diminish the rate of residual disease in intact canal wall cholesteatoma surgery.


METHODS
Prospective controlled parallel group study.


METHODS
Two neighboring district general hospitals, one with a KTP laser and one without.


METHODS
All patients undergoing staged intact canal wall surgery for cholesteatoma.


METHODS
Staged intact canal wall surgery for cholesteatoma.


METHODS
Presence or absence of residual disease at the second stage operation, performed at least 12 months after the first operation.


RESULTS
Thirty-three patients underwent treatment without and 36 underwent treatment with the laser. Ten patients without laser treatment had residual disease, whereas one patient had residual disease after laser treatment (p = 0.003). After adjustment using logistic regression, treatment still has a significant effect on outcome (p = 0.013). The number needed to treat is four.


CONCLUSIONS
Ancillary use of the KTP laser in cholesteatoma surgery is a treatment that significantly improves complete removal of disease.
Hamilton
John W
JW
Department of Otolaryngology, Gloucestershire Hospitals Trust, Gloucester, UK. john.hamilton@dial.pipex.com
D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D004424:Ear Canal / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors