Abstract
Objective: 1) To describe a cost-effective, minimally invasive technique for treating tympanic membrane atelectasis, and 2) to present data on hearing improvement in patients receiving this as the basis for a future prospective study. Study Design: Report of hearing and clinical outcome over a 4-year period. Setting: Tertiary center. Patients: Patients with tympanic membrane atelectasis and hearing loss. Intervention: Valsalva, hydrodissection, or manual dissection reinflated the atelectatic segment under mask anesthesia. A CO 2 laser hand-held fiber contracted the tympanic membrane. Then, myringotomy and pressure equalizing tube placement was performed. Main Outcome Measures: Status of the tympanic membrane, patency of the tubes, and pure tone average air-bone gap on preoperative, postoperative, and most recent audiograms. Results: Laser myringoplasty was performed on 60 ears of 43 patients. The average preoperative air-bone gap was 15 dB, and this significantly improved to 7dB (p < 0.001) postoperatively. Hearing improvement remained significant in the 17 patients with greater than 2 years' follow-up (7 dB, p = 0.007). Patients with effusion had worse preoperative air-bone gap (19dB) compared with dry ears (12.5 dB, p = 0.02). However, postoperative and long-term air-bone gaps were not significantly different in the 2 groups (p = 0.3). Patients with myringostapediopexy that required or failed mechanical elevation did not have significant hearing improvement. Conclusion: Laser myringoplasty for treatment of tympanic membrane atelectasis using a hand-held flexible fiber CO2 laser is feasible and may improve hearing immediately and long term. It is not useful in severe adherent atelectasis. More studies are indicated to confirm its overall cost-effectiveness and competitiveness with traditional methods of managing atelectasis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1694-1698 |
| Number of pages | 5 |
| Journal | Otology and Neurotology |
| Volume | 34 |
| Issue number | 9 |
| DOIs | |
| State | Published - Aug 30 2013 |
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Keywords
- Atelectasis
- CO laser
- Hearing
- Myringoplasty
- Retraction pocket
ASJC Scopus subject areas
- Otorhinolaryngology
- Sensory Systems
- Clinical Neurology
Cite this
CO2 laser myringoplasty : A minimally invasive technique for treating tympanic membrane atelectasis. / Ryan, Marisa; Kaylie, David.
In: Otology and Neurotology, Vol. 34, No. 9, 30.08.2013, p. 1694-1698.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - CO2 laser myringoplasty
T2 - A minimally invasive technique for treating tympanic membrane atelectasis
AU - Ryan, Marisa
AU - Kaylie, David
PY - 2013/8/30
Y1 - 2013/8/30
N2 - Objective: 1) To describe a cost-effective, minimally invasive technique for treating tympanic membrane atelectasis, and 2) to present data on hearing improvement in patients receiving this as the basis for a future prospective study. Study Design: Report of hearing and clinical outcome over a 4-year period. Setting: Tertiary center. Patients: Patients with tympanic membrane atelectasis and hearing loss. Intervention: Valsalva, hydrodissection, or manual dissection reinflated the atelectatic segment under mask anesthesia. A CO 2 laser hand-held fiber contracted the tympanic membrane. Then, myringotomy and pressure equalizing tube placement was performed. Main Outcome Measures: Status of the tympanic membrane, patency of the tubes, and pure tone average air-bone gap on preoperative, postoperative, and most recent audiograms. Results: Laser myringoplasty was performed on 60 ears of 43 patients. The average preoperative air-bone gap was 15 dB, and this significantly improved to 7dB (p < 0.001) postoperatively. Hearing improvement remained significant in the 17 patients with greater than 2 years' follow-up (7 dB, p = 0.007). Patients with effusion had worse preoperative air-bone gap (19dB) compared with dry ears (12.5 dB, p = 0.02). However, postoperative and long-term air-bone gaps were not significantly different in the 2 groups (p = 0.3). Patients with myringostapediopexy that required or failed mechanical elevation did not have significant hearing improvement. Conclusion: Laser myringoplasty for treatment of tympanic membrane atelectasis using a hand-held flexible fiber CO2 laser is feasible and may improve hearing immediately and long term. It is not useful in severe adherent atelectasis. More studies are indicated to confirm its overall cost-effectiveness and competitiveness with traditional methods of managing atelectasis.
AB - Objective: 1) To describe a cost-effective, minimally invasive technique for treating tympanic membrane atelectasis, and 2) to present data on hearing improvement in patients receiving this as the basis for a future prospective study. Study Design: Report of hearing and clinical outcome over a 4-year period. Setting: Tertiary center. Patients: Patients with tympanic membrane atelectasis and hearing loss. Intervention: Valsalva, hydrodissection, or manual dissection reinflated the atelectatic segment under mask anesthesia. A CO 2 laser hand-held fiber contracted the tympanic membrane. Then, myringotomy and pressure equalizing tube placement was performed. Main Outcome Measures: Status of the tympanic membrane, patency of the tubes, and pure tone average air-bone gap on preoperative, postoperative, and most recent audiograms. Results: Laser myringoplasty was performed on 60 ears of 43 patients. The average preoperative air-bone gap was 15 dB, and this significantly improved to 7dB (p < 0.001) postoperatively. Hearing improvement remained significant in the 17 patients with greater than 2 years' follow-up (7 dB, p = 0.007). Patients with effusion had worse preoperative air-bone gap (19dB) compared with dry ears (12.5 dB, p = 0.02). However, postoperative and long-term air-bone gaps were not significantly different in the 2 groups (p = 0.3). Patients with myringostapediopexy that required or failed mechanical elevation did not have significant hearing improvement. Conclusion: Laser myringoplasty for treatment of tympanic membrane atelectasis using a hand-held flexible fiber CO2 laser is feasible and may improve hearing immediately and long term. It is not useful in severe adherent atelectasis. More studies are indicated to confirm its overall cost-effectiveness and competitiveness with traditional methods of managing atelectasis.
KW - Atelectasis
KW - CO laser
KW - Hearing
KW - Myringoplasty
KW - Retraction pocket
UR - http://www.scopus.com/inward/record.url?scp=84892800781&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84892800781&partnerID=8YFLogxK
U2 - 10.1097/MAO.0b013e31829a36e8
DO - 10.1097/MAO.0b013e31829a36e8
M3 - Article
C2 - 23988992
AN - SCOPUS:84892800781
VL - 34
SP - 1694
EP - 1698
JO - Otology and Neurotology
JF - Otology and Neurotology
SN - 1531-7129
IS - 9
ER -