OBJECTIVE: To determine the most effective method of short-term middle ear aeration in patients unable to tolerate hyperbaric oxygen (HBO) therapy. STUDY DESIGN: Prospective study comparing two methods of short-term tympanostomy in each patient. METHODS: Seventeen adult patients were referred for management of barotitis and inability to tolerate hyperbaric oxygen therapy (HBO). Each patient underwent CO2 laser tympanostomy on the right ear and tympanostomy with T-tube placement in the left ear. The tube was removed on completion of HBO. Patients were asked to rate pain and their satisfaction with each method of tympanostomy using a visual analog scale. Otorrhea, persistent perforation, recurrent barotitis, hearing loss, and otalgia occurring during the study period were documented. RESULTS: Laser tympanostomy was associated with a significantly lower incidence of otorrhea but was attended by recurrent barotitis in four of 16 patients. Laser tympanostomy was perceived as being less painful and was rated higher in overall satisfaction. CONCLUSIONS: Laser tympanostomy is an effective method for management of barotitis in patients unable to tolerate HBO. Otorrhea is significantly reduced, although a risk of recurrent barotitis exists if the laser perforation closes prior to completion of HBO. Both methods of short-term tympanostomy reduce complications when compared with a retrospective cohort.
OBJECTIVE: To determine the most effective method of short-term middle ear aeration in patients unable to tolerate hyperbaric oxygen (HBO) therapy. STUDY DESIGN: Prospective study comparing two methods of short-term tympanostomy in each patient. METHODS: Seventeen adult patients were referred for management of barotitis and inability to tolerate hyperbaric oxygen therapy (HBO). Each patient underwent CO2 laser tympanostomy on the right ear and tympanostomy with T-tube placement in the left ear. The tube was removed on completion of HBO. Patients were asked to rate pain and their satisfaction with each method of tympanostomy using a visual analog scale. Otorrhea, persistent perforation, recurrent barotitis, hearing loss, and otalgia occurring during the study period were documented. RESULTS: Laser tympanostomy was associated with a significantly lower incidence of otorrhea but was attended by recurrent barotitis in four of 16 patients. Laser tympanostomy was perceived as being less painful and was rated higher in overall satisfaction. CONCLUSIONS: Laser tympanostomy is an effective method for management of barotitis in patients unable to tolerate HBO. Otorrhea is significantly reduced, although a risk of recurrent barotitis exists if the laser perforation closes prior to completion of HBO. Both methods of short-term tympanostomy reduce complications when compared with a retrospective cohort.