Vincenzo Vincenti1, Jacques Magnan, Maria Silvia Saccardi, Carlo Zini. 1. *Unit of Audiology and Pediatric Otorhinolaryngology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy; †Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Nord-Chemin des Bourrelly, Marseille, France; and ‡Area of Otolaryngology, Rome American Hospital, Rome, Italy.
Abstract
OBJECTIVE: To investigate whether the use of mesna (sodium 2-mercaptoethanesulfonate), a mucolytic agent capable of breaking disulfur bonds, reduces the frequency of residual cholesteatoma in canal wall up tympanomastoidectomy. STUDY DESIGN: Retrospective study. SETTING: Tertiary care otology and skull base centers. PATIENTS: Two hundred fourteen patients operated on by means of canal wall up tympanomastoidectomy for a middle ear cholesteatoma. INTERVENTIONS: Planned staged canal wall up tympanomastoidectomy. In the study group, the cholesteatoma removal was performed with the support of chemically assisted dissection by using mesna. In the control group, the dissection of the disease was performed by means of a traditional mechanical technique alone. MAIN OUTCOME MEASURES: Prevalence of residual cholesteatoma at the second-stage operation in the 2 groups of study. RESULTS: One hundred eight patients were treated with the ancillary use of mesna and one hundred six without chemically assisted dissection. A residual cholesteatoma was found in 12 (11.1%) of the 108 patients treated with chemically assisted dissection and in 26 (24.5%) of the 106 patients treated with mechanical dissection. After adjusting for potential confounders, CADISS procedure was associated with a significantly lower risk of having residual cholesteatoma (OR, 0.39; 95% CI, 0.18-0.84, p = 0.02). CONCLUSION: This study showed that chemically assisted dissection by using mesna represents a valid support in reducing the frequency of residual disease in cholesteatoma surgery.
OBJECTIVE: To investigate whether the use of mesna (sodium 2-mercaptoethanesulfonate), a mucolytic agent capable of breaking disulfur bonds, reduces the frequency of residual cholesteatoma in canal wall up tympanomastoidectomy. STUDY DESIGN: Retrospective study. SETTING: Tertiary care otology and skull base centers. PATIENTS: Two hundred fourteen patients operated on by means of canal wall up tympanomastoidectomy for a middle ear cholesteatoma. INTERVENTIONS: Planned staged canal wall up tympanomastoidectomy. In the study group, the cholesteatoma removal was performed with the support of chemically assisted dissection by using mesna. In the control group, the dissection of the disease was performed by means of a traditional mechanical technique alone. MAIN OUTCOME MEASURES: Prevalence of residual cholesteatoma at the second-stage operation in the 2 groups of study. RESULTS: One hundred eight patients were treated with the ancillary use of mesna and one hundred six without chemically assisted dissection. A residual cholesteatoma was found in 12 (11.1%) of the 108 patients treated with chemically assisted dissection and in 26 (24.5%) of the 106 patients treated with mechanical dissection. After adjusting for potential confounders, CADISS procedure was associated with a significantly lower risk of having residual cholesteatoma (OR, 0.39; 95% CI, 0.18-0.84, p = 0.02). CONCLUSION: This study showed that chemically assisted dissection by using mesna represents a valid support in reducing the frequency of residual disease in cholesteatoma surgery.
Authors: Oğuz Kadir Eğilmez; Numan Kökten; Mustafa Baran; M Tayyar Kalcıoğlu; Işın Doğan Ekici; Muhammet Tekin Journal: J Int Adv Otol Date: 2018-08 Impact factor: 1.017
Authors: Adrianus H A Baazil; Maura C Eggink; Maarten J F De Wolf; Fenna A Ebbens; Frederik G Dikkers; Erik van Spronsen Journal: Eur Arch Otorhinolaryngol Date: 2021-08-22 Impact factor: 3.236
Authors: M Tayyar Kalcioglu; Ali Ozerk; Oguz Kadir Egilmez; Numan Kokten; Lokman Uzun; Yuksel Toplu; Muhammet Tekin Journal: Medeni Med J Date: 2019-12-26