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Updated: May 28, 2026
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Re-evaluation of CO₂ laser myringotomy for managing children with persistent acute otitis media
Yen-Ling Kuo1, Mao-Che Wang, Chia-Huei Chu
1Department of Otolaryngology and Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Insights
CO(2) laser myringotomy effectively treats persistent acute otitis media (PAOM) in children. This procedure aids in middle ear fluid drainage and pathogen identification, offering an alternative to prolonged antibiotic use.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Surgical Innovation
Background:
- Persistent acute otitis media (PAOM) presents a challenge in pediatric care.
- Re-evaluating the efficacy of CO(2) laser myringotomy for PAOM is crucial.
Purpose of the Study:
- To assess the clinical utility of CO(2) laser myringotomy in managing pediatric PAOM.
- To investigate the diagnostic and therapeutic benefits of the procedure.
Main Methods:
- A cohort of 40 children with PAOM underwent CO(2) laser myringotomy.
- Pre-procedure assessment included videotelescopy, audiometry, and tympanometry.
- Middle ear effusion was collected for culture post-myringotomy, with 3-month follow-up.
Main Results:
- The study included 53 ears from 40 children; 20% had bilateral disease.
- Streptococcus pneumoniae was the most frequent pathogen (28.3% culture rate).
- A 62.5% resolution rate was observed at 1 month; all eardrums healed within 30 days.
Conclusions:
- CO(2) laser myringotomy is a viable treatment option for pediatric PAOM.
- The procedure facilitates middle ear effusion culture, identifying common pathogens like S. pneumoniae.
- It offers a way to manage PAOM, potentially reducing the need for extended medication.
Background:
This study aimed to re-evaluate the utility of CO(2) laser myringotomy in children with persistent acute otitis media (PAOM).
Methods:
From September 2002 to April 2008, 40 children with PAOM received CO(2) laser myringotomy. PAOM was defined as continuing symptoms and signs after systemic antibiotic treatment. Before laser myringotomy, the eardrums were checked under videotelescopy, pure tone audiometry or behavior audiometry and tympanometry. Middle ear effusions were collected using our own designed bottle culture device after laser myringotomy. The patients were followed up at outpatient clinics for 3 months. Cultured middle ear pathogens, healing time of the eardrums, hospital course (for admitted patients), and the development of middle ear effusions were recorded.
Results:
Forty children with 53 ears with PAOM were enrolled. Eight patients (20%) had bilateral disease and underwent bilateral laser myringotomy. The overall culture rate was 28.3%, and Streptococcus pneumoniae was the most common pathogen. Eight patients (20%) were admitted for intravenous antibiotics. The average eardrum healing time was 22 days in those with positive cultures, and 16.4 days in those with negative cultures (p=0.125). All eardrums healed in 1 month. The resolution rate was 62.5% at 1 month. Patients with bilateral PAOM were prone to have positive middle ear culture (5/8) compared with those with unilateral PAOM (8/32) (p=0.086).
Conclusion:
CO(2) laser myringotomy is an applicable means of treating PAOM. S pneumoniae is the most common pathogen in PAOM. CO(2) laser myringotomy allows for the drainage and culture sampling of middle ear effusion, relieving the need of taking prolonged medication.
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