How we do it: laser reduction of peri-tubal adenoids in selected patients with otitis media with effusion.
. The literature supports the benefit of adenoidectomy in patients with otitis media with effusion (OME). . It is difficult to clear adenoid tissue from around the Eustachian tubes using curettes and this conventional method of adenoidectomy is contra-indicated in patients with cleft palates. . Laser reduction of peri-Eustachian adenoid tissue without myringotomies or grommet insertion was performed in three patients with OME. Two patients had previous adenoidectomies performed with curettes and one patient had a cleft palate. . In all three patients, the OME resolved and all had closure of the air-bone gap that was maintained during long-term follow-up (14 months-4 years). . This technique resolved OME without the need for myringotomies or grommet insertion and should be considered particularly in patients who have peri-tubal recurrence of adenoidal tissue following conventional adenoidectomy or in patients with cleft palate where there is concern with regards to palatal incompetence.
Smith
W
W
Department of Otolaryngology, Addenbrookes Hospital NHS Trust, Hills Road, Cambridge, UK. grommetsmith@doctors.org.uk
Yung
M
M
D000158:Acoustic Impedance Tests; D000233:Adenoidectomy; D000234:Adenoids / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D005064:Eustachian Tube / Q000473:pathology; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008876:Middle Ear Ventilation; D009225:Myringoplasty; D010034:Otitis Media with Effusion / Q000601:surgery*; D038781:Otoscopy