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Is Gelfoam Necessary for Middle Ear Surgery: A Comparative Study of the Results of Tympanoplasty With and Without Gelfoam in the Middle Ear

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Abstract

Absorbable gelatin sponge (Gelfoam) has been used for many years in middle ear surgeries. It not only provides support to the graft and ossicular reconstruction materials but also helps in haemostasis and aeration of the middle ear. Although gelfoam is generally well tolerated but fibrosis and granulations in the mesotympanum have been attributed to its usage in some studies. This study was conducted to compare the results of middle ear surgeries with and without gel foam in terms of both objective and subjective improvements of symptoms. To study the outcome of tympanoplasty with and without gel foam in the middle war by measuring following attributes (for measuring outcomes) at an intervals of 6 weeks, 12 weeks and 6 months after surgery. (a) Graft take up rate as evaluated by otoscopy. (b) Pre and post-operative hearing levels as measured on Pure Tone Audiogram. (c) Subjective improvement in symptoms of ear discharge, heaviness in ears, hearing loss and tinnitus. Study design-prospective clinical study. patients undergoing tympanoplasty type 1 between August 2018 to July 2019 were included in the study. Group A (n = 36) consisted of patients who underwent tympanoplasty with gel foam in the middle ear and Group B (n = 36) consisted of patients who underwent tympanoplasty without any gel foam inside the middle ear. The uptake of graft after tympanoplasty was almost similar in the patients using gelfoam (89%) and those without gelfoam (84%) at the end of 6 months. The improvement in the subjective symptoms of ear discharge and hearing loss at 6 weeks following the surgery was better in patients without gelfoam whereas, at the end of 6 months the improvement in these symptoms was similar in both the groups. The improvement in hearing 6 months following tympanoplasty as assessed by pure tone audiometry and was found to be the same in both the groups. Tympanoplasty can be performed safely without using any gelfoam in the ear. This not only makes patients comfortable early but also avoids any gelfoam induced fibrosis or granulations in the middle ear.

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Author notes

  1. Rohit Kumar Jha

    Present address: Gandhinagar Hospital, Coal India Ltd, CCL, Ranchi, India

  2. Somak Majumdar

    Present address: Diamond Harbour Govt. Medical College, Kolkata, India

  3. Nikhil

    Present address: Shravya Speech and Hearing Clinic, Patna, India

Authors and Affiliations

  1. Department of ENT, All India Institute of Medical Sciences Patna, Patna, India

    Kranti Bhavana, Rohit Kumar Jha &  Nikhil

  2. Department of Community and Family Medicine, All India Institute of Medical Sciences Patna, Patna, India

    Somak Majumdar

Authors
  1. Kranti Bhavana
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  2. Rohit Kumar Jha
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  3. Somak Majumdar
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  4. Nikhil
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Correspondence to Rohit Kumar Jha.

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No potential conflict of interest was reported by the authors.

Ethical Standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional guidelines on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Approval of Institute Ethical Committee (IEC) of AIIMS,(IEC/AIIMS/PAT/100/2016) Patna was obtained prior to the beginning of the study.

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Bhavana, K., Jha, R.K., Majumdar, S. et al. Is Gelfoam Necessary for Middle Ear Surgery: A Comparative Study of the Results of Tympanoplasty With and Without Gelfoam in the Middle Ear. Indian J Otolaryngol Head Neck Surg 74 (Suppl 1), 281–287 (2022). https://doi.org/10.1007/s12070-020-02057-8

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  • DOI: https://doi.org/10.1007/s12070-020-02057-8

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