The clinical application and efficacy of sodium hyaluronate-carboxymethylcellulose during tympanomastoid surgery.

Abstract

To evaluate the anti-adhesive and anti-inflammatory effects of sodium hyaluronate-carboxymethylcellulose (HA-CMC) on postoperative hearing improvement and complications during tympanomastoid surgery. Prospective controlled clinical trial. 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. 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. These findings suggest that combined application of Gelfoam with HA-CMC may be beneficial in patients undergoing tympanomastoid surgery.