Joong Ho Ahn1, Hyun Woo Lim, Hye-Ran Hong. 1. Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. meniere@amc.seoul.kr
Abstract
OBJECTIVES/HYPOTHESIS: To evaluate the anti-adhesive and anti-inflammatory effects of sodium hyaluronate-carboxymethylcellulose (HA-CMC) on postoperative hearing improvement and complications during tympanomastoid surgery. STUDY DESIGN: Prospective controlled clinical trial. METHODS: We evaluated 287 patients who underwent type I tympanoplasty, with or without canal wall up mastoidectomy, between January 2007 and June 2010. Postoperative hearing and complications were compared in the 143 patients who receivedGelfoam soaked with HA-CMC during myringoplasty and the 144 patients who received Gelfoam only. RESULTS: There were no significant between-group differences in sex, age, and preoperative hearing status. However, average postoperative air-bone gap (13.7 ± 8.5 dB vs. 17.2 ± 9.9 dB) and the number of air-bone gaps smaller than 10 dB (40.6% vs. 24.3%) were significantly improved in the HA-CMC compared with the control group. In addition, the rates of re-otorrhea, reperforation of the tympanic membrane (TM), postoperative TM adhesion, and reoperation were lower in the HA-CMC than in the control group without significances. CONCLUSIONS: These findings suggest that combined application of Gelfoam with HA-CMC may be beneficial in patients undergoing tympanomastoid surgery.
RCT Entities:
OBJECTIVES/HYPOTHESIS: To evaluate the anti-adhesive and anti-inflammatory effects of sodium hyaluronate-carboxymethylcellulose (HA-CMC) on postoperative hearing improvement and complications during tympanomastoid surgery. STUDY DESIGN: Prospective controlled clinical trial. METHODS: We evaluated 287 patients who underwent type I tympanoplasty, with or without canal wall up mastoidectomy, between January 2007 and June 2010. Postoperative hearing and complications were compared in the 143 patients who received Gelfoam soaked with HA-CMC during myringoplasty and the 144 patients who received Gelfoam only. RESULTS: There were no significant between-group differences in sex, age, and preoperative hearing status. However, average postoperative air-bone gap (13.7 ± 8.5 dB vs. 17.2 ± 9.9 dB) and the number of air-bone gaps smaller than 10 dB (40.6% vs. 24.3%) were significantly improved in the HA-CMC compared with the control group. In addition, the rates of re-otorrhea, reperforation of the tympanic membrane (TM), postoperative TM adhesion, and reoperation were lower in the HA-CMC than in the control group without significances. CONCLUSIONS: These findings suggest that combined application of Gelfoam with HA-CMC may be beneficial in patients undergoing tympanomastoid surgery.
Authors: Dong Sik Bae; Jung-Woo Woo; Se Hyun Paek; Hyungju Kwon; Young Jun Chai; Su-Jin Kim; June Young Choi; Kyu Eun Lee; Yeo-Kyu Youn Journal: J Korean Surg Soc Date: 2013-10-25