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Keywords:

  • Hyaluronic acid;
  • Gelfoam;
  • packing;
  • middle ear;
  • tympanoplasty;
  • Level of Evidence: 2c.

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 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. Laryngoscope, 2012