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Efficacy of middle-ear packing in success of type 1 tympanoplasty: a prospective randomised study

Published online by Cambridge University Press:  26 July 2021

S R Sahoo ,
J Tripathi ,
S Kumari  and
S Rastogi
S R Sahoo
Affiliation:
Department of ENT, Tata Motors Hospital Jamshedpur, Jharkhand, India
J Tripathi
Affiliation:
Department of ENT, Tata Motors Hospital Jamshedpur, Jharkhand, India
S Kumari
Affiliation:
Department of ENT, Tata Motors Hospital Jamshedpur, Jharkhand, India
S Rastogi*
Affiliation:
Department of ENT, Tata Motors Hospital Jamshedpur, Jharkhand, India
*
Author for correspondence: Dr Shalabh Rastogi, Department of ENT, Tata Motors Hospital, Telco Colony, Jamshedpur, Jharkhand 831004, India E-mail: shalabh.rastogi@tatamotors.com
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Abstract

Objective

A prospective randomised study was undertaken to compare the results of type 1 tympanoplasty with and without middle-ear packing with gelfoam.

Method

Eighty patients undergoing type 1 tympanoplasty were randomised into two groups according to packing in the middle ear: with gelfoam and without gelfoam. The data in terms of graft uptake rate, hearing gain and subjective improvement were analysed at one and three months.

Results

The graft uptake rate between both groups did not show a statistically significant difference. There was conductive hearing loss in the gelfoam group in the early post-operative period. Subjectively, patients were more comfortable with respect to heaviness and hearing gain than in the non-gelfoam group.

Conclusion

Gelfoam use in middle-ear packing is not an essential step and causes more discomfort in patients during the early post-operative period. It should be a surgeon's choice to use it when and where it is necessary.

Keywords

Type-1 TympanoplastyGelfoamMiddle Ear Packing

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 10 , October 2021 , pp. 864 - 868
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr S Rastogi takes responsibility for the integrity of the content of the paper

References

Joseph, RB. The effects of absorbable gelatin sponge preparations and other agents on scar formation in the dog's middle ear: an experimental histopathologic study. Laryngoscope 1962;72:1528–4810.1288/00005537-196211000-00003CrossRefGoogle Scholar
Revesz, G. The use of lyophilized plasma substance in tympanoplasty. J Laryngol Otol 1961;75:985–910.1017/S002221510005876XCrossRefGoogle ScholarPubMed
Krupala, JL, Gianoli, GJ, Smith, RA. The efficacy of hyaluronic acid foam as a middle ear packing agent in experimental tympanoplasty. Am J Otol 1998;19:546–50Google ScholarPubMed
Shen, Y, The, BM, Friedland, PL, Eikelboom, RH, Atlas, MD. To pack or not to pack? A contemporary review of middle ear packing agents. Laryngoscope 2011;121:1040–810.1002/lary.21470CrossRefGoogle ScholarPubMed
Hellstrom, S, Salen, B, Stenfors, LE. Absorbable gelatin sponge (Gelfoam) in otosurgery: one cause of undesirable postoperative results? Acta Otolaryngol 1983;96:269–7510.3109/00016488309132899CrossRefGoogle ScholarPubMed
Correll, JT, Prentice, HR, Wise, EC. Biologic investigations of a new absorbable sponge. Surg Gynecol Obstet 1945;81:585–9Google Scholar
Zollner, F. The prognosis of the operative improvement of hearing in chronic middle ear infections. Ann Otol Rhinol Laryngol 1957;66:907–1710.1177/000348945706600401CrossRefGoogle ScholarPubMed
Wullstein, H. The restoration of the function of the middle ear, in chronic otitis media. Ann Otol Rhinol Laryngol 1956;65:1021–4110.1177/000348945606500416CrossRefGoogle ScholarPubMed
Ohsaki, K, Saito, R. Tissue reaction to middle ear prostheses: in vivo observation (rabbit ear lobe) of polyethylene tube, stainless steel wire and absorbable gelatin sponge used in middle ear surgery. Acta Med Okayama 1976;30:321–39Google ScholarPubMed
Sakagami, M, Yuasa, R, Yuasa, Y. Simple underlay myringoplasty. J Laryngol Otol 2007;121:840–410.1017/S0022215106005561CrossRefGoogle ScholarPubMed
Li, Y, Lianga, J, Cheng, Y, Zhanga, Q, Rena, X, Shenga, Y. Anterosuperior anchoring myringoplasty using cyanoacrylate glue can prevent packing gelfoam in the middle ear cavity. Eur Ann Otorhinolaryngol Head Neck dis 2018;135:95–810.1016/j.anorl.2017.04.002CrossRefGoogle ScholarPubMed
Rastogi, S, Pandit, R, Vasamsetty, PKVD. Modified technique of underlay myringoplasty. J Otolaryngol ENT Res 2018;10:269‒72Google Scholar
Malhotra, M, Malhotra, R, Varshney, S, Priya, M, Bhardwaj, A, Tyagi, A et al. A historical review of Indian perspectives on techniques of tympanoplasty. Int J Otolaryngol 2020:1408270Google ScholarPubMed
Primrose, WJ, Kerr, AG. The anterior marginal perforation. Clin Otolaryngol Allied Sci 1986;11:175–610.1111/j.1365-2273.1986.tb00125.xCrossRefGoogle ScholarPubMed
Gristwood, R, Venables, W. Factor influencing the outcome in type I tympanoplasty. Aust J Otolaryngol 1993;4:319–23Google Scholar
Hung, T, Knight, JR, Sankar, V. Anterosuperior anchoring myringoplasty technique for anterior and subtotal perforations. Clin Otolaryngol Allied Sci 2004;29:210–410.1111/j.1365-2273.2004.00805.xCrossRefGoogle ScholarPubMed
Ghiasi, S, Tootonochi, SJ. Tympanoplasty without use of gel-foam in the middle ear. Iran J Otorhinolaryngol 2008;20:65–70Google Scholar
Kim, W, King, J, AL-Swiahb, J, Park, S, Jeong, C, Kim, D, et al. Do we always need gelfoam packing in the middle-ear cavity during tympanoplasty? J Laryngol Otol 2016;130:19110.1017/S002221511600596XCrossRefGoogle Scholar
Li, G, Feghali, JG, Dinces, E, McElveen, J, van de Water, TR. Evaluation of esterified hyaluronic acid as middle ear-packing material. Arch Otolaryngol Head Neck Surg 2001;127:534–910.1001/archotol.127.5.534CrossRefGoogle ScholarPubMed
Cho, YS, Lee, HS, Hong, SH, Chung, WH, Min, JY, Hwang, SJ. Effects of packing on the postoperative hearing after middle ear surgery. Acta Otolaryngol Suppl 2007;127:67–7210.1080/03655230701624897CrossRefGoogle Scholar
Aihara, Y, Ohyama, Y, Ushio, K, Kamio, T, Sakuma, A, Ohkawara, D et al. Patient's satisfaction with tympanoplasty. Otol Jpn 2002;12:103–8Google Scholar
Baba, S, Fujikura, T, Pawankar, R, Yagi, T. Subjective evaluation of post-tympanoplasty hearing in relation to the pure tone threshold. Auris Nasus Larynx 2004;31:347–5110.1016/j.anl.2004.03.010CrossRefGoogle ScholarPubMed
Baba, S, Yagi, T, Fujikura, T. Subjective evaluation and overall satisfaction after tympanoplasty for chronic suppurative otitis media. J Nippon Med Sch 2004;71:17–2410.1272/jnms.71.17CrossRefGoogle Scholar