Effectiveness of CO2 laser-assisted surgical treatment in acute otitis media with effusion

Abstract

Purpose: To assess effectiveness of CO2-laser light in myringotomy in patients having acute otitis media with effusion. Material and methods. 172 patients with acute otitis media and effusion were taken into the study. Multispiral computed tomography, as early diagnostics, was prescribed to all such patients. The obtained findings helped to decide if conservative treatment would be effective or to choose surgical intervention – laser myringotomy with CO2-laser. During examination of temporal bones with CT, specialists were looking for the effusion in cavities of the middle ear, bone-destructive and other pathological changes as well as they were measuring the eardrum thickness. Patients who were selected for surgical treatment were divided into two groups: Group 1 – patients with eardrum thickness equal to or less than 0.5 mm (n = 44); Group 2 – patients with eardrum thickness more than 0.5 mm (n = 30). Results. It has been found out that the optimal laser power which perforates the eardrum with a given diameter after a single exposure is 18 W if the tympanic membrane thickness is equal to or less than 0.5 mm; if the eardrum thickness is more than 0.5 mm, the optimal power is 22 W. Conclusion. Laser myringotomy is an effective method of surgical treatment of patients having acute otitis media with effusion. This technique drains the middle ear without intra-operative and postoperative complications. While making myringotomy with CO2-laser, one has to consider patient’s eardrum thickness.