Emory Report

April 12, 1999

 Volume 51, No. 27

Laser procedure clears up chronic childhood middle ear infections

The scenario is all too common-- parents who return over and over again to the pediatrician's office, hoping desperately that this time an antibiotic will cure their child's recurrent ear infection once and for all. Often the frustration finally ends with the treatment of last resort--a trip to the hospital for tubes inserted into the ears to drain trapped fluid.

Using a new technology, Emory physicians are breaking the cycle of chronic ear infections with a minimally invasive treatment that quickly and easily drains the fluid buildup caused by middle ear infections. Called OtoLAM, the new technique uses a computer-driven laser to create a tiny hole in the eardrum that immediately results in pain relief and draining of fluid. Using a video monitor, the physician pinpoints the exact location for the hole in the eardrum. The ventilation provided by the hole prevents fluid buildup and provides time for the underlying infection to clear. Over the course of a few weeks, the hole naturally closes and heals by itself.

OtoLAM is performed in the physician's office using only ear drops for anesthesia. Parents stay with their child during the procedure, which takes less than five minutes once the ear drops have taken effect. Follow-up visits may be necessary to monitor drainage and healing, but the only other after-care required is putting cotton in the ears before showering or swimming.

"OtoLAM is a very effective approach that we can use at the first sign of a problematic ear infection," said department chair Douglas Mattox. "With this increased ability to promote drainage early on, we can prevent infections from becoming recurrent episodes that often lead to chronic infection and occasionally to serious hearing problems."

A number of clinical trials have been conducted over the past several years to evaluate OtoLAM, and a large, multi-center study is currently underway. In initial results, normal, healthy ears were reported in 80 percent of children one to 12 weeks after the OtoLAM procedure, while in 15 percent an ear infection recurred. When infection recurs, OtoLAM can be safely and easily repeated.

Middle ear infections are an extremely common childhood illness, occurring in one-third of all children three or more times before their third birthdays. These infections cause fluid to become trapped in the middle ear. In some children, fluid remains in the ear for weeks or even months, sometimes leading to recurrent, acute middle ear infections. This can lead to hearing impairment and problems with language development or even permanent hearing loss.

Antibiotics alone are often not effective for ear infections and overprescription of antibiotics can lead to antibiotic resistance. In the past, the most effective treatment for chronic fluid buildup was inserting small tubes into the eardrum. This surgical procedure requires general anesthesia, which results in postoperative grogginess and sometimes side effects. OtoLAM offers a less invasive means of ventilating the middle ear, although children with severe infection or associated enlarged adenoids will still need the standard procedure.

For more information about OtoLAM, call 404-778-3381 or call Emory HealthConnection at 404-778-7777 to make an appointment with a physician.

--Holly Korschun

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