Bozkurt Mete Kaan, Calgüner Mustafa
Department of Otolaryngology, Medicine Faculty of Ankara University, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2004;12(3-4):55-9.
We evaluated the efficacy of CO2 laser myringotomy combined with adenoidectomy in children with serous otitis media (SOM) unresponsive to medical therapy and compared the recurrences in the follow-up period with the control group who underwent adenoidectomy and ventilation tube (VT) insertion.
The CO2 laser myringotomy group included 25 children with a mean age of 5.6 years and there were 10 children with a mean age of 6.3 years in the VT control group. The laser used was a Sharplan 1030 CO2 laser, attached to Zeiss Universal S3 operation microscope with a 300 mm objective, using a Microspot optical delivery system.
The mean (+/-SD) healing time was 13 (+/-2.16) days in 4 ears with myringotomies less than 2 mm in diameter, and 25 (+/-2.34) days in 46 ears with myringotomies with 2 mm in diameter. During the 6-month follow-up period, there were 11 recurrences (22%) in the CO2 laser group and 4 recurrences (20%) in the control group, which was not statistically significant (p>0.05).
We prefer laser myringotomy in SOM cases who do not need long-time middle ear ventilation; we use the ventilation tubes in cases with thick mucoid effusion and recurrent effusion after laser myringotomy.
我们评估了二氧化碳激光鼓膜切开术联合腺样体切除术对药物治疗无效的小儿分泌性中耳炎（SOM）的疗效，并将随访期内的复发率与接受腺样体切除术和置管（VT）的对照组进行比较。
二氧化碳激光鼓膜切开术组包括25名平均年龄5.6岁的儿童，VT对照组有10名平均年龄6.3岁的儿童。使用的激光是Sharplan 1030二氧化碳激光，连接到蔡司通用S3手术显微镜，物镜为300mm，采用微光斑光学传输系统。
直径小于2mm鼓膜切开术的4只耳平均（±标准差）愈合时间为13（±2.16）天，直径2mm鼓膜切开术的46只耳平均愈合时间为25（±2.34）天。在6个月的随访期内，二氧化碳激光组有11例复发（22%），对照组有4例复发（20%），差异无统计学意义（p>0.05）。
对于不需要长时间中耳通气的SOM病例，我们更倾向于激光鼓膜切开术；对于激光鼓膜切开术后有浓稠黏液性积液和复发性积液的病例，我们使用通气管。
