[CO2 laser tympanostomy without ventilation tubes]

A new tympanostomy procedure, by CO2 laser and without ventilation tubes, which is known as tympanolaserostomy or laser-assisted tympanostomy (LAT), was compared with traditional tympanostomy with tubes. Since 1990, we have operated on 168 ears using a CO2 laser fitted with an adapter to an operative microscope. Multiple low-power impacts (0.8-1.0 W in 0.1 s) focused on a minimal spot (0. 18 mm) were preferred. This intervention did not require anesthesia and produced circular orifices 2.0 to 2.5 mm in diameter that closed in 30-40 days. Compared with 168 ears operated by tympanostomy with tubes, laser tympanostomy produced similar rates of auditive recovery by one month and only 15% of recurrence by 6 months. Recurrences were treated with laser or with tubes if prolonged ventilation was planned. After 1 to 4 years, does not require anesthesia, tubes, or hospitalization, it reduces risk and complications, and consequently decreases costs.