Use of the flexible fiber CO2 laser in pediatric transcanal endoscopic middle ear surgery

We describe 4 pediatric patients (age 6-11 years) who underwent transcanal endoscopic ear surgery (TEES) with the assistance of a flexible fiber CO2 laser over a period of 6 months. Three of these individuals suffered from densely adherent cholesteatoma, where the laser permitted one-handed dissection while preserving endoscopic visualization by limiting bleeding. In the fourth patient, TEES ossiculoplasty was performed for a congenital stapes bar, with subsequent hearing improvement. Advantages and disadvantages of the flexible fiber CO2 laser in the setting of TEES are discussed. Use of the flexible fiber CO2 laser was found to expand the TEES toolkit.