Laser-assisted tympanomastoidectomy for active mucosal chronic otitis media
M. D. Wilkie and J. Tahery
Department of Otorhinolaryngology, Head & Neck Surgery, Countess of Chester Hospital, Chester, United Kingdom
Tympanoplasty/methods; mastoid/surgery; otitis media, suppurative/surgery; laser therapy; treat▯ment out-come
125 - 130
Abstract. Laser-assisted tympanomastoidectomy for active mucosal chronic otitis media. Objectives: Achieving disease control in the context of active granulating mucosal chronic otitis media (COM) is typically challenging. Adjuvant laser use in cholesteatomatous COM surgery enhances disease clearance, yet its role in mucosal COM remains unexplored. The purpose of this study is to present the outcomes and our experience of the latter, and to attempt to define the role of this approach in managing mucosal COM. Methods: Patients that underwent primary laser­assisted tympanomastoidectomy (2007­2012) for active granulating mucosal COM with at least six months follow­up were studied. Disease control was defined by successful tympanic membrane repair and resolution of otorrhoea. Time­to­event analysis using the Kaplan­Meier method was used to gain a temporal estimate of disease control. Results: Seventy ears (66 patients) were included with mean follow­up of 22 months (6­50 months). Disease control was achieved in 94.3% of cases at latest follow­up, while one­ and two­year temporal estimates of control were 97.1% and 91.8% respectively. A mean post­operative four­frequency air­bone gap of ≤20 dB was achieved in 52 cases (74.3%). Surgicalcomplicationsincludedtransientvertigo(n=2),woundinfection(n=2),andtemporaryfacialnervepalsy(n=1). Conclusions: We present disease control rates favourable to other published series of active mucosal COM, supporting the use of the laser as an efficacious adjunct to tympanomastoid surgery in this context. This initial report should foster further appraisal of this approach in larger prospective studies.
Vol. 12, 2016, 2nd trimester

Laser-assisted tympanomastoidectomy for active mucosal chronic otitis media