Optimizing effectiveness of laser tympanic membrane fenestration in chronic otitis media with effusion: Clinical and technical considerations

Objective: To describe the patient, disease and clinical characteristics that optimize the effectiveness of laser tympanic membrane fenestration (LTMF) to treat chronic otitis media with effusion (OME). Setting: Four pediatric otolaryngology tertiary referral centers. IRB approved; participation by informed consent. Methods: An observational clinical effectiveness trial was conducted in 164 ears (94 children), who had chronic OME. All patients were candidates for insertion of pressure equalization tubes (PETs) but agreed to undergo LTMF instead. Clinical and audiologic follow-up are reported at 90 days after LTMF. Outcome Measures: Clinical effectiveness was defined as an effusion free middle ear at otoscopy with A or C1 tympanogram and normal hearing. Results: At 90 days, 66% of the 95 evaluable ears were effusion free, all with normal hearing. Children younger than 4 years ( P