orabase and Otitis-Media

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.

Topics: Carboxymethylcellulose Sodium; Drug Carriers; Female; Follow-Up Studies; Humans; Hyaluronic Acid; Male; Mastoid; Middle Aged; Otitis Media; Postoperative Complications; Prospective Studies; Single-Blind Method; Tissue Adhesions; Treatment Outcome; Tympanic Membrane; Tympanoplasty; Viscosupplements

We describe the histopathology of ossicular grafts and implants so as to provide insight into factors that may influence functional results after surgery for chronic otitis media.. Histopathologic observations were made on 56 cases: 50 surgical specimens and 6 temporal bone cases in which the graft was sectioned in situ.. Autogenous malleus, incus, and cortical bone grafts behaved in a similar manner and maintained their morphological size, shape, and contour for extended periods of time, at least up to 30 years. These histopathologic observations support the continued use of autograft ossicular and cortical bone grafts for middle ear reconstruction. Cartilage grafts developed chondromalacia with resulting loss of stiffness and showed a tendency to undergo resorption. Synthetic prostheses made of porous plastic (Plastipore, Polycel) elicited foreign body giant cell reactions with various degrees of biodegradation of the implants. Prostheses made of hydroxyapatite and Bioglass were enveloped by a lining of connective tissue and mucosal epithelium. The Bioglass material was broken down into small fragments and partially resorbed by a host response within the middle ear. These results warrant caution in the use of prostheses made of porous plastic or Bioglass.

Topics: Adolescent; Adult; Aged, 80 and over; Bone Resorption; Bone Transplantation; Carboxymethylcellulose Sodium; Ceramics; Child; Chronic Disease; Ear Cartilage; Ear Ossicles; Foreign-Body Reaction; Giant Cells, Foreign-Body; Humans; Middle Aged; Ossicular Prosthesis; Osteocytes; Otitis Media; Polyethylenes; Polypropylenes; Prosthesis Failure