Abstract
Objectives
Granular myringitis (GM) is a troublesome disease with a high incidence of recurrence and relapse. CO2 laser vaporisation and trichloroacetic acid (TAA) have been applied in treating several otological diseases, both with favorable therapeutic efficacy. However, long-term therapeutic efficacy of both CO2 laser vaporisation and TAA cauterisation against GM have not yet been evaluated. We aimed to investigate the therapeutic potential of CO2 laser vaporisation and TAA cauterisation in GM management.
Study Design
Prospective, randomised study
Participants
A total of 88 GM patients who failed therapy with boric acid, alcohol, and glycerin ear drop (BAAG) otic solution between July 2009 and January 2018 were included. Participants were randomly assigned to receive CO2 laser vaporisation (n = 39) or TAA cauterisation (n = 49).
Main outcome measures
Main outcomes were treatment success, complications after four months of treatment, and recurrence within 4-12 months after treatment.
Results
The success rate was significantly higher in the CO2 group than in the TAA group (94.9% vs. 77.6%, p=0.023). After four months of treatment, the GM recurrence rate was comparable between the two groups (13.5% vs. 18.4%, p=0.562). The CO2 laser group had one case of perforation and one case of severe vertigo, while one participant in the TAA cauterisation group experienced hearing loss.
Conclusion
Both TAA cauterisation and CO2 laser vaporisation are safe and effective treatments for GM. The success rate of CO2 laser vaporisation for treating GM is higher than that of TAA cauterisation. Recurrence rates are comparable within one year.
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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,