Open AccessCO2 Laser for De-epithelialization in Tympanoplasty
Author(s) -
Lakshmi Nair,
Neil Gildener-Leapman,
Steven M. Parnes
Publication year - 2018
Publication title -
indian journal of otolaryngology and head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.229
H-Index - 22
eISSN - 2231-3796
pISSN - 0973-7707
DOI - 10.1007/s12070-018-1430-4
Subject(s) - medicine , tympanoplasty , surgery , perforation , audiogram , tympanic membrane perforation , carbon dioxide laser , otorhinolaryngology , laser , hearing loss , laser surgery , audiology , materials science , punching , physics , optics , metallurgy
Tympanoplasty repairs tympanic membrane perforations but also covers an umbrella of procedures characterized by surgery of the mastoid bone. Tympanoplasty is widely regarded as a beneficial procedure with an over 90% graft closure success rate and an over 80% return to normal hearing range. Though surgical technique and graft type are important in determining surgical outcomes of the procedure, results are most greatly correlated with location of the perforation. Marginal perforations are associated with the most complications in reconstruction of the tympanic membrane, lack of vascularization and limited membrane area delaying the healing process (4). Lasers have been used in medical procedures dating back to the 1960s. The advantage of infrared lasers such as CO 2 are the precision of cutting and the smooth interaction with tissues (5). The CO 2 laser is absorbed by the tympanic membrane and does not damage the middle ear while visible lasers penetrate and can damage the ear drum (6). This retrospective study of 150 patients from 2013-2016 assesses and demonstrates the viability of using carbon dioxide laser as an alternative to the traditional method for de-epithelialization of tympanic perforation margins during tympanoplasty. By comparing closure rates and audiogram data, this study reveals parameters of use, benefits and adverse outcomes on healing and hearing restoration with the CO 2 laser-assisted method. Perforation closure rate of 91% and hearing improvement in 66% of patients was observed. Fourteen patients did not undergo closure of the tympanic membrane with an overwhelming majority of the 14 having large and marginal perforations.