Advancing Minimally Invasive Surgery: Laser Ablation for Chronic Otitis Media, Proctologic Fistulas, and Gynecological Conditions

Background: Laser ablation has emerged as a promising minimally invasive technique for treating various soft tissue disorders. However, its application in otitis media, proctologic fistulas, and gynecological conditions remains underexplored. Traditional surgical methods often involve extensive tissue dissection, prolonged recovery, and a higher risk of complications. The Laser Ablation System provides a precision-based approach with reduced intraoperative bleeding, minimal tissue damage, and improved healing outcomes. Objective: To evaluate the safety, efficacy, and clinical outcomes of the Laser Ablation System in the treatment of chronic otitis media and proctologic fistulas, with an additional focus on its potential applications in gynecology. Methods: A prospective case series was conducted on four patients (ages 18-65) diagnosed with chronic otitis media (n=3) and a proctologic fistula (n=1). All underwent laser-assisted procedures, including tympanoplasty, tympanomastoidectomy, and fistula treatment. The 1470 nm diode laser was applied via endovenous delivery through a bare-tipped laser fiber (400-750 µm diameter). Procedures were performed under local anesthesia with real-time ultrasound guidance. Outcome measures included healing time, symptom resolution, and recurrence rates. Results:  Otitis Media Cases: Complete resolution of infection with significant hearing restoration and no recurrence at 3- month follow-up.  Proctologic Fistula: Full healing achieved with no postoperative complications or recurrence at 6-month followup.  Overall Surgical Outcomes: o Minimal intraoperative bleeding and improved visualization. o Reduced postoperative pain (VAS score reduction from 7 to 2). o Shorter healing time compared to conventional surgery. o No adverse effects, including scarring or delayed wound healing. Conclusion: The Laser Ablation System demonstrated high safety and efficacy in treating chronic otitis media and proctologic fistulas. The precision of diode lasers facilitated minimally invasive interventions, reducing recovery time and improving patient outcomes. These findings support the potential of laser technology as a viable alternative to conventional surgical approaches. Further studies with larger cohorts and extended follow-ups are recommended to explore its broader applications in ENT, proctology, and gynecology. Keywords: Laser Ablation, Otitis Media, Proctologic Fistula, Minimally Invasive Surgery, Diode Laser, Tympanoplasty, Postoperative Healing.