Home Journal List JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD Volume 28 Article Details

LASERMYRINGOTOMYVERSUSVENTILATIONTUBESINOTITISMEDIAWITHEFFUSION

Abstract

Background:Otitismediawitheffusion(OME)isaleadingcauseofdifficultyinhearinginpaediat-ricpopulation.Otitismediawitheffusionmustbedetectedandmanagedearlytopreventconductivehearinglossinchildren.Itwasaimedtocompareresultsoflasermyringotomyandventilationtubeinsertion,intermsofhearingimprovementandrecurrenceofMiddleeareffusion(MEE).Methods:ThisrandomizedcontrolledtrialwasconductedfromFebruary2012toJanuary2015.Childrenof4–12yearsofagewithdecreasedhearingduetoOMEwereincludedinthestudy.Thesechildrenwereinvestigatedwithpuretoneaudiometry(PTA)andtympanometrytoconfirmconductivehearingloss.Patientswereputin2groups,grouponecomprisedofpatientstreatedwithlasermyringotomyandgroup2,treatedwithventilationtubeinsertion.Theobjectivewastoevaluateandcomparere-sultsofthetwoproceduresintermsofresolutionofmiddleeareffusion(MEE)andimprovementofhearing.Thetwoprocedureswerealsocomparedintermsofcomplicationslikeotorrhea,persistenceofperforation,hypertrophicscarandthinningoftympanicmembrane(TM).Results:Middleearef-fusionclearedin35outof68earswithlasermyringotomy(LM)ascomparedto52outof62earswithventilationtubes(VT).Themyringotomywasstillpatentin21earstreatedwithLMwhiletubewasinsitein50yearswithVTafter3months.ThehearinglevelimprovedwithLMby10–15dBafterfirst3months.Conclusion:TheaiminOtitismediawitheffusionisventilationoftympaniccavity.Lasermyringotomycanbesubstitutetoventilationtubeinsertion(VT).ButitremainspatentforshortertimeandlesseffectivethanVT.TheearswithrefractoryorrecurrentMEEshouldhaveVTinsertion

Download