title: Laser-assisted myringotomy versus conventional myringotomy with ventilation tube insertion in treatment of otitis media with effusion: Long-term follow-up.
abstract: BACKGROUND
  Otitis media with effusion is the most common cause of conductive hearing loss in the pediatric population. Insertion of ventilation tubes with or without adenoidectomy is the accepted and standard surgical procedure. CO2 laser myringotomy without tube placement has been advocated as an alternative treatment.
  
  
  OBJECTIVE
  To compare long-term follow-up results of laser versus classical myringotomy with ventilation tube insertion over five years.
  
  
  METHODS
  86 patients with bilateral otitis media with effusion were divided into two groups: laser myringotomy group and myringotomy with ventilation tube insertion group, with follow-up in hearing results and recurrence rates over five years.
  
  
  RESULTS
  The mean patency time of myringotomy in laser group was 23 days, while the mean patency time of the ventilation tubes ears was 4.0 months in myringotomy group. Twelve patients in laser group (13.9%) showed a recurrent otitis media with effusion compared to 9 patients in myringotomy group (10.4%).
  
  
  CONCLUSIONS
  Laser fenestration is a less effective alternative to myringotomy and tube placement. The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, Suez Canal University Ismailia Egypt.
authors.forename: Tarek Fouad
authors.initials: TF
authors.lastname: Youssef
authors.forename: Mohamed Rifaat
authors.initials: MR
authors.lastname: Ahmed
keywords: otitis media with effusion; ventilation tubes, CO2 laser myringotomy