Introduction
Eustachian tube dysfunction is very common and is the predominant cause of otitis media with effusion. Negative middle ear pressure generated by Eustachian tube dysfunction can cause deformation of the collagen layer in the ear drum. Collagen becomes stretched and looses its orderly array. Over time, deep retraction pockets form. If left untreated, the tympanic membrane becomes prone to cholesteatoma formation. CO2 laser energy interacts with collagen and causes it to return to its natural configuration.