Efficacy of the KTP laser in the treatment of middle ear cholesteatoma.

OBJECTIVE: To evaluate whether ancillary use of the KTP (potassium titanyl phosphate) laser can diminish the rate of residual disease in intact canal wall cholesteatoma surgery. STUDY DESIGN: Prospective controlled parallel group study. SETTING: Two neighboring district general hospitals, one with a KTP laser and one without. PATIENTS: All patients undergoing staged intact canal wall surgery for cholesteatoma. INTERVENTION: Staged intact canal wall surgery for cholesteatoma. MAIN OUTCOME MEASURE: Presence or absence of residual disease at the second stage operation, performed at least 12 months after the first operation. RESULTS: Thirty-three patients underwent treatment without and 36 underwent treatment with the laser. Ten patients without laser treatment had residual disease, whereas one patient had residual disease after laser treatment (p = 0.003). After adjustment using logistic regression, treatment still has a significant effect on outcome (p = 0.013). The number needed to treat is four. DISCUSSION: Ancillary use of the KTP laser in cholesteatoma surgery is a treatment that significantly improves complete removal of disease.