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Yen-Fu Cheng, MD; An-Suey Shiao, MD

Arch Otolaryngol Head Neck Surg. 2008;134(2):152-156.

Objective  To determine the effect of carbon dioxide laser microsurgery in the treatment of intractable chronic myringitis (CM).

Design  Retrospective 10-year case note review.

Setting  Tertiary referral hospital.

Patients  We reviewed retrospective case notes for 30 treated ears in 29 consecutive patients with CM (ie, loss of the tympanic membrane for longer than 1 month, refractory to conservative medical treatment) who underwent carbon dioxide laser microsurgery between 1995 and 2004, excluding patients who had undergone previous otologic surgery such as tympanoplasty.

Interventions  Carbon dioxide laser microsurgery for resurfacing the nonepithelialized tympanic membrane was performed using local anesthesia.

Main Outcome Measures  Resolution of disease in the affected tympanic membrane.

Results  Of 30 affected ears, 22 demonstrated total resolution of CM, 7 demonstrated partial resolution, and the status of 1 ear remained unchanged at the end of follow-up (mean,19.7 months). Revision laser therapy was performed in 3 ears, resulting in total resolution of disease in 1 ear. Time to total resolution of disease ranged from 1 to 16 months (mean, 2.95 months).

Conclusions  We used carbon dioxide laser microsurgery to treat intractable primary CM and describe its efficacy in a retrospective review of laser resurfacing covering 10 years. We believe that laser microsurgery has the advantages of less invasiveness and higher applicability compared with aggressive surgical treatment. In patients with CM refractory to conservative medical treatment, carbon dioxide laser microsurgery could be an effective alternative when aggressive surgical procedures are not under consideration.

Author Affiliations: Department of Otorhinolaryngology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan. Dr Cheng is now with the Center for Hearing and Communication Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.

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