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Gold laser adenoidectomy: long-term safety and efficacy results
Jonathan B Ida1, N Knight Worley, Ronald G Amedee
1Tulane University School of Medicine, Department of Otolaryngology, 1430 Tulane Avenue, SL-59, New Orleans, LA 70112, USA. bigyonatan@yahoo.com
Insights
Gold laser adenoidectomy with pressure equalization tubes (PET) offers favorable long-term outcomes for pediatric chronic otitis media with effusion. Otorrhea and middle ear effusion rates remained low after tube extrusion, indicating a safe and effective treatment.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Devices
Background:
- Chronic otitis media with effusion (COME) is a common pediatric condition.
- Adenoid hypertrophy often contributes to COME.
- Pressure equalization tubes (PETs) are frequently used to manage COME.
Purpose of the Study:
- To evaluate the long-term efficacy of Gold laser adenoidectomy combined with PET placement.
- To assess the incidence of otorrhea and middle ear effusion post-PET extrusion.
Main Methods:
- A prospective study of 50 pediatric patients (8-48 months) undergoing Gold laser adenoidectomy with PET placement.
- Patients were evaluated at 8, 12, and 16 months post-operatively.
- Otorrhea, PET extrusion, and middle ear status were recorded.
Main Results:
- Low incidence of otorrhea: 6% at 8 months, 0% at 12 months, and 4% at 16 months.
- High rate of clear middle ears post-PET extrusion: 97% of those with extruded tubes had clear middle ears at 16 months.
- Overall, 98% of patients had clear middle ears at the final examination.
Conclusions:
- Gold laser adenoidectomy with PET placement demonstrates favorable long-term results for COME.
- The technique shows comparable or superior outcomes to other reported methods.
- This combined approach is effective for managing adenoid hypertrophy and COME in children.
Objectives:
To report the long-term results of Gold laser adenoidectomy with pressure equalization tube (PET) placement by measuring the incidence of otorrhea and middle ear effusion after tube extrusion.
Study Design:
A prospective study of 50 patients, ages 8-48 months, that underwent Gold laser adenoidectomy with PE tube placement in a pediatric outpatient setting.
Methods:
We previously reported the initial results at 4 months post-op of 50 patients treated for adenoid hypertrophy and chronic otitis media with effusion (COME). All patients were then evaluated at 8, 12, and 16 months post-operatively. The incidence of otorrhea, extrusion of the PE tubes, and middle ear status was recorded.
Results:
The incidence of otorrhea was 3/50 (6%) at 8 months, 0 (0%) at 12 months, and 2 (4%) at 16 months. At 16 months, the PE tubes had extruded in 29 (58%) and 28/29 (97%) of these had clear middle ears. Forty-nine patients (98%) overall had clear middle ears at the last exam. One patient required a second set of tubes.
Conclusion:
The long-term results of Gold laser adenoidectomy with PE tube placement for adenoid hypertrophy and COME compare favorably with the initial report of the technique, as well as with other techniques as reported in other studies.
