• Mohammad Yousaf abbottabad international medical college
  • Suhail Ahmad Malik
  • Tahir Haroon


Background: Otitis media with effusion (OME) is a leading cause of difficulty in hearing in paediatric population. Otitis media with effusion must be detected and managed early to prevent conductivehearing loss in children. It was aimed to compare results of laser myringotomy and ventilation tubeinsertion, in terms of hearing improvement and recurrence of Middle ear effusion (MEE). Methods:This randomized controlled trial was conducted from February 2012 to January 2015. Children of 4–12 years of age with decreased hearing due to OME were included in the study. These children wereinvestigated with pure tone audiometry (PTA) and tympanometry to confirm conductive hearingloss. Patients were put in 2 groups, group one comprised of patients treated with laser myringotomyand group 2, treated with ventilation tube insertion. The objective was to evaluate and compare results of the two procedures in terms of resolution of middle ear effusion (MEE) and improvement ofhearing. The two procedures were also compared in terms of complications like otorrhea, persistenceof perforation, hypertrophic scar and thinning of tympanic membrane (TM). Results: Middle ear effusion cleared in 35 out of 68 ears with laser myringotomy (LM) as compared to 52 out of 62 earswith ventilation tubes (VT). The myringotomy was still patent in 21 ears treated with LM while tubewas in site in 50 years with VT after 3 months. The hearing level improved with LM by 10–15 dBafter first 3 months. Conclusion: The aim in Otitis media with effusion is ventilation of tympaniccavity. Laser myringotomy can be substitute to ventilation tube insertion (VT). But it remains patentfor shorter time and less effective than VT. The ears with refractory or recurrent MEE should haveVT insertion.Keywords: Otitis media with effusion; Middle ear effusion; Laser myringotomy; Ventilation tubes;Tympanometry

Author Biographies

Mohammad Yousaf, abbottabad international medical college

associate professor otolaryngology

Suhail Ahmad Malik

associate professorotolaryngology


Rosenfeld R. What to expect from medical treatment of otitis media. Paediatr Infect Dis J 1995;14(9):731–7.

Yousaf M, Inayatullah, Khan F. Medical versus surgical management of otitis media with effusion in children. J Ayub Med Coll Abbottabad 2012;24(1):83–5.

Yousaf M, Malik SA, Zada B. Laser myringotomy and incisional myringotomy in children with otitis media with effusion. J Ayub Med Coll Abbottabad 2014;26(4):441–4.

Koopman JP, Reuchli AG, Kummer EE, Boumans LJ, Rijnties E, Hoeve LJ, et al. Laser myringotomy versus ventilation tubes in children with otitis media with effusion: a randomised trial. Laryngoscope 2004;114(5):844–9.

Youssef TF, Ahmed MR. Laser-assisted myringotomy versus conventional myringotomy with ventilation tube insertion in treatment of otitis media with effusion: long-term follow-up. Interv Med Appl Sci 2013;5(1):16–20.

Roberts JE, Rosenfeld RM, Zeisel SA. Otitis Media and Speech and Language: A Meta-analysis of Prospective Studies. Paediatrics 2004;113(3 Pt 1):e238–48.

Szeremeta W, Parameswaran MS, Issacson G. Adenoidectomy with Laser or Incisional Myringotomy for Otitis Media with Effusion. laryngoscope 2000;110(3 Pt 1):342–5.

Hegazy MH. Diode laser myringotomy for short-term middle ear ventilation (a pilot study on children). Egypt J Otolaryngol 2013;29(4):230–4.

Sedlmaier B, Jivanjee A, Gutzler R, Huscher D, Jovanovic S. Ventilation Time of the Middle Ear in Otitis Media With Effusion (OME) After CO2 Laser Myringotomy. Laryngoscope 2002;112(4):661–8.

D’Eredit R, Shah UK. Contac diode laser myringotomy for medium duration middle ear ventilation in children. Int J Paediatr Otorhinolaryngol 2006;70(6):1077–88.

Cotter CS, Kosko JR. Effectiveness of laser assisted myringotomy for otitis media in children. Laryngoscope 2004;114(3):486–9.

Poyrazoglu E, Cinicik H, Gungor A, Gurpinar B, Yildirim S, Candan H. The effects of incisional myringotomy and CO2 laser myringotomy on rat tympanic membranes. Int J Paediatr Otorhinolaryngol 2004;68(6):811–5.

Zanetti D, Piccioni M, Nassif N, Campovecchi C, Redaelli de Zinis LO. Diode laser myringotomy for chronic otitis media with effusion in adults. Otol Neurotol 2005;26(1):12–8.

Cohen D, Shechter Y, Slatkine M, Gatt N, Perez R. Laser Myringotomy in Different Age Groups. Arch Otolaryngol Head Neck Surg 2001;127(3):260–4.

American Academy of Family Physicians, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. Otitis media with effusion. Pediatrics 2004;113(5):1412–29.

Chang CW, Yang YW, Fu CY, Shiao AS. Differences between children and adults with otitis media with effusion treated with CO(2) laser myringotomy. J Chin Med Assoc 2012;75(1):29–35.

Lin SH, Lai CC, Shiao AS. CO2 laser myringotomy in children with otitis media with effusion. J Laryngol Otol 2006;120(3):188–92.



Most read articles by the same author(s)