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Abstract

OBJECTIVE: To investigate the use of contact diode laser myringotomy (C-LAM), combined with topical mitomycin C, as an alternative method for prolonged middle ear ventilation in children with otitis media with effusion.

STUDY DESIGN AND SETTING: Prospective study at a tertiary care pediatric institution.

METHODS: Fifteen children enrolled in the study. Mitomycin C was applied to the intact tympanic membrane in the right ears, whereas saline on the left side was used for controls. C-LAM was then performed in all ears. Outcome measures included healing rate and scarring, ear infection, and long-term audiometric follow-up.

RESULTS: There was no significant difference in median healing rate. In each group, the median was between the third and fourth month. Normal hearing thresholds were obtained in all children at 2-year follow-up.

CONCLUSION: C-LAM proved to be an effective method for medium-term ventilation, but topical mitomycin C before C-LAM did not prolong patency rate in our patients. No significant complication was encountered at 2-year follow-up. (Otolaryngol Head Neck Surg 2004;130:742-6.)

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References

Gates

Cost-effectiveness considerations in otitis media treatment. Otolaryngol Head Neck Surg 1996;114:525–30.

Alsarraf

Gates

Economic costs and consequences. In: Rosenfeld

Bluestone

, editors. Evidence-based otitis media. Hamilton: B.C. Decker; 1999. pp. 285–93.

Owings

Kozak

Ambulatory and inpatient procedures in the United States, 1996. Vital Health Stat 13 1998;Nov(139):1–119.

Stickler

The attack on the tympanic membrane. Pediatrics 1984;74:291–2.

Freeman

Fireman

Evaluation of ventilation tubes and myringotomy with and without tympanostomy tubes for chronic otitis media with effusion. Pediatr Infect Dis J 1991;11:10–2.

Buckingham

Cholesteatoma and chronic otitis media following middle ear intubation. Laryngoscope 1981;91:1450–6.

Lildholdt

Ventilation tube in secretory otitis media. Acta Otolaryngol Suppl (Stockh) 1983;393:1–28.

Luxford

Sheehy

Myringotomy and ventilation tubes: A report of 1,568 ears. Laryngoscope 1982;92:1293–9.

Gates

Avery

Prihoda

Delayed onset post-tympanostomy otorrhea. Otolaryngol Head Neck Surg 1988;98:111–5.

10.

Mandel

Rockette

Bluestone

Efficacy of myringotomy with and without tympanostomy tubes for chronic otitis media with effusion. Pediatr Infect Dis J 1992;11:270–7.

11.

Goode

Long-term middle ear ventilation with T tubes: The perforation problem. Otolaryngol Head Neck Surg 1996;115:500–1.

12.

Wilpizeski

Maioriella

Reddy

Otological applications of lasers: Basic background. Trans Pa Acad Ophthalmol Otolaryngol 1977;30:185–92.

13.

Goode

CO2 laser myringotomy. Laryngoscope 1982;92:420–3.

14.

DeRowe

Ophir

Katzir

Experimental study of CO2 laser myringotomy with a hand-held otoscope and fiberoptic delivery system. Lasers Surg Med 1994;15:248–53.

15.

Silverstein

Kuhn

Choo

Laser-assisted tympanostomy. Laryngoscope 1995;106:67–74.

16.

Cohen

Siegel

Krespi

Middle ear laser office ventilation (LOV) with a CO2 flashscanner. J Clin Laser Med Surg 1998;16:107–9.

17.

Kupin

Juzych

Shin

Adjunctive mitomycin C in primary trabeculectomy in phakic eyes. Am J Ophthalmol 1995;119:30–9.

18.

Megevand

Salmon

Scholtz

The effect of reducing exposure time of mitomycin C in glaucoma filtering surgery. Ophthalmology 1995;102:84–90.

19.

Yamamoto

Varani

Soong

Effects of 5 fluorouracil and mitomycin C on cultured rat fibroblasts. Ophthalmology 1990;97:1204–10.

20.

Ingrams

Volk

Biesman

Sinus surgery: Does mitomycin C reduce stenosis?

Laryngoscope 1998;108:883–6.

21.

Ward

April

Mitomycin C in the treatment of tracheal cicatrix after tracheal reconstruction. Int J Pediatr Otorhinolaryngol 1998;44:221–6.

22.

Spector

Werkhaven

Spector

Preservation of function and histologic appearance in the injured glottis with topical mitomycin C. Laryngoscope 1999;109(7 pt 1):1125–9.

23.

Estrem

Batra

Preventing myringotomy closure with topical mitomycin C in rats. Otolaryngol Head Neck Surg 1999;120:794–8.

24.

Estrem

VanLeeuwen

Use of mitomycin C for maintaining myringotomy patency. Otolaryngol Head Neck Surg 2000;122:8–10.

25.

Estrem

Baker

Preapplication of mitomycin C for enhanced patency of myringotomy. Otolaryngol Head Neck Surg 2000;122:346–8.

26.

O'Reilly

Goldman

Widner

Creating a stable membrane perforation using mitomycin C. Otolaryngol Head Neck Surg 2001;124:40–5.

27.

Jassir

Buchman

Gomez-Marin

Safety and efficacy of topical mytomicin C in myringotomy patency. Otolaryngol Head Neck Surg 2001;124:368–73.

28.

Siegel

Brodsky

Waner

Office-based laser assisted tympanic membrane fenestration in adults and children: Pilot data to support an alternative to traditional approaches to otitis media. Int J Pediatr Otorhinolaryngol 2000;53:111–20.

29.

Costa

Spaeth

Eiferman

Wound healing modulation in glaucoma filtration surgery. Ophthalmic Surg 1993;3:152–70.

Contact Diode Laser Myringotomy and Mitomycin C in Children

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References