Laser Procedure Provides Alternative to Tubes for Ear Infection

Sept. 27, 1999 (Minneapolis) - A new laser procedure that can be performed right in the doctor's office without anesthesia could reduce the need to place tubes in the ears of people with chronic middle ear infections. Linda Brodsky, MD, who presented the results of her research in New Orleans at the 103rd Annual Meeting of the American Academy of Otolaryngology/Head and Neck Surgery, says laser-assisted myringotomy (LAM) involves using a laser to create a small hole in the eardrum so that trapped fluid can drain.

The hole remains open for several weeks, says Brodsky. In contrast, a hole made by a needle puncture would close in 24 hours if no tubes were inserted.

"At one end of the spectrum, we have over-relied on antibiotics and steroids, to treat [ear infections]," Brodsky tells WebMD. "At the other end, we have been reluctant to use ventilation tubes except for the most chronic cases. For patients with moderate [but] persistent problems, we had no appropriate treatment." Brodsky is the director of the ear, nose, and throat (ENT) division at Children's Hospital of Buffalo, where she is a professor of ENT at State University of New York, Buffalo.

When patients with middle ear infections undergo LAM, the physician also can extract the fluid behind the eardrum to determine whether antibiotics are warranted, and if so, which ones. For patients who still need ventilation tubes, the physician can use LAM to guide the tube without putting the patient under anesthesia.

A person would be a candidate for LAM if he or she has had four or more episodes of acute middle ear infections in three months, or if his or her infection seems resistant to antibiotics, Brodsky tells WebMD.

"I have been interested in this [treatment], but I wanted to see how it fared in trials," says Beatriz Silvarra, MD, an ENT specialist in private practice in Denver. She says now that she has seen the results of Brodsky's study, she is taking LAM seriously. "Now I'm going to be going to look at this equipment as a[n] addition to my practice."

The research was funded by ESC/Sharplan, the makers of the device used in LAM. Brodsky has no proprietary interest in the device or in the company.