Middle Ear Laser Office Ventilation (LOV) with a CO 2 Laser Flashscanner

Abstract

Background: Laser assisted ventilation of the middle ear with a defocused laser beam has been performed on adults in an office setting without anesthesia. Objective: The purpose of this study was to evaluate the efficacy and safety of a highly controlled, char-free CO₂ flashscanner technology for the ventilation of the middle ear in young children, at this stage under general anesthesia, and later without anesthesia. Methods: A CO₂ flashscanning laser, in conjunction with a micromanipulator, was used on 21 SOM patients ages 3–7 years old, with followup at 2 months. Operating time is approximately 5 minutes. Results: Postoperative results show average patency of 2–3 weeks without adverse effects. Of the treated patients, 53% did not require a second treatment, whereas 47% still suffered from otitis media and needed a second treatment. Conclusion: The CO₂ flashscanner laser technology is effective and safe for middle ear ventilation and provides excellent control of the perforation diameter. It is already being performed in an office setting with sedation on a limited basis with very promising preliminary results. Based on the current study and on 70 additional cases with longer interval followup, we anticipate the office technique to become widely used in the future.