Laser-assisted tympanostomy in pediatric patients with serous otitis media.
OBJECTIVE
To evaluate prognostic factors related with cure rate, in pediatric patients with serous otitis media treated with laser-assisted tympanostomy without ventilation tubes, in a single institution.


METHODS
The procedure was performed on 124 ears in 88 individuals, from 3 to 14 years old. External auditory canal anatomy, type of anesthesia, tympanic membrane and middle ear fluid characteristics, myringotomy size, and laser parameters, in relation to cure rate, were accordingly studied.


RESULTS
The overall cure rate by ear at the end of the 2-month follow-up period was 54.83%, whereas 45.17% still suffered from otitis media. Multivariate statistical analysis demonstrated that the presence of a thick tympanic membrane is significantly correlated with pure outcome in children with serous otitis media, when laser-assisted tympanostomy without ventilation tubes is performed favoring a worse cure rate (P < 0.023). Other parameters did not statistically correlate with the outcome. A 41% parental dissatisfaction rate was noticed.


CONCLUSIONS
This study addresses selection bias for children with serous otitis media, candidates for laser-assisted tympanostomy. These are related to the duration of serous otitis media, the condition of middle ear mucosa, the thickness of the tympanic membrane, the type of anesthesia, and the cost of laser apparatus. There is likely to be a causal relationship between outcome and tympanic membrane appearance in children undergoing laser-assisted tympanostomy.
Prokopakis
Emmanuel P
EP
Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece. epro@med.uoc.gr
Lachanas
Vassilios A
VA
Christodoulou
Panayotis N
PN
Velegrakis
George A
GA
Helidonis
Emmanuel S
ES
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000601:surgery*; D018579:Patient Selection; D011446:Prospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology