Laser-myringoplasty for adhesive otitis media

Introduction Chronic dysfunction of the Eustachian tube leads to retraction of the tympanic membrane with or without effusion and can result in tympanic membrane atelectasis or even cholesteatoma. The retrospective study addressed the question whether tympanic membrane mobilisation in combination with laser-myringoplasty can eliminate atelectasis.

Material and methods: Over a period of 12 months 13 patients, 9 children (ū: 9,2 yrs) and 4 adults (ū: 34,5 yrs) and 20 tympanic membranes with atelectasis were treated. In 9 patients this was combined with balloon Eustachian tuboplasty, one child had her residual adenoids removed, and one adult female had her inferior turbinates coagulated and lateralized to improve ventilation.

Results Saline solution was injected into the middle ear to mechanically mobilize the tympanic membrane. The redundant tympanic membrane was shrunk with a defocussed CO₂- Laser (2 W) coupled into the microscope. In 1 case mobilization was not successful and the child received a formal tympanoplasty. In 17/20 cases a tympanostomy tube was placed at the same time. 2 patients developed postoperative otorhea and were treated with antibiotics. More than 80 %  of tympanic membranes had a normal appearance after 6 weeks in otomicroscopy. Tympanic membranes tightened in the correct plane.

Conclusion The retrospective study shows that tympanic membrane mobilisation and laser shrinking, in combination with surgical improvement of Eustachian tube function can reverse middle ear atelectasis. In most cases treated with laser myringoplasty formal tympanoplasty becomes unnecessary.

Poster-PDF A-1715.pdf

Publication History

Article published online:
13 May 2021