Does intraoperative ciprofloxacin‐soaked gelfoam have adverse effects on graft success rate? A randomized, double‐blind controlled trial

Abstract

Objectives: The aim of this study was to evaluate whether intraoperative ciprofloxacin-soaked gelfoam is safe in tympanoplasty or not.Method: In this randomized, double-blind controlled clinical study, we included 100 patients between 18 and 60 years old, having perforation ≥50% of the tympanic membrane and dry ear for at least 2 months who were a candidate for underlay tympanoplasty via postauricular approach. We used ciprofloxacin soaked gelfoam in the case group and betamethasone soaked gelfoam in the control group for packing the middle ear cavity and external auditory canal during their operation. The graft success rate and tympanogram after 6 months follow-up period was considered as the primary outcome. Also, we evaluated the postoperative hearing results 6 months after the surgery as the secondary outcomes.Results: Postoperative microscopic otoscopy showed a graft success rate of 100% (44/44) and 97.7% (42/43) in the case and control groups, respectively. The level of improvement between the two groups was not significant for air-bone gap (ciprofloxacin: 9.01 ± 7.89 dB, betamethasone 5.31 ± 10.53 dB, P = .160), and speech reception thresholds (SRT; ciprofloxacin: 10.23 ± 8.62 dB, betamethasone 7.33 ± 12.60 dB, P = .260). 93.2% of all the ears in the case group and 81.4% of those in the control group achieved postoperative air-bone gap within 20 dB, but the difference between them was not significant (P = .118). Conclusions:We found that the application of ciprofloxacin impregnated gelfoam in the middle ear, and the external auditory canal had no adverse effect on the graft success rate in tympanoplasty. Levels of evidence: 1b.

A Post-marketing Surveillance, Single-Centric Study to Evaluate the Safety and Tolerability of VELNEZ as a Space-Occupying Dressing Pack After Ear Surgery

“…In previous studies [7,8], non-absorbable packs were found to be very uncomfortable for patients postoperatively and painful to remove. To overcome the disadvantages associated with nonabsorbable packs, a variety of biodegradable ear packs have been developed [9][10][11]. Absorbable ear packing materials are effective as they accelerate the overall healing process and improve postoperative hearing [3].…”

Comparison of the underlay and over‐underlay tympanoplasty: A randomized, double‐blind controlled trial

“…The aim of COM surgery is the reconstruction of tympanic membrane (TM) perforation and the establishment of a sound‐conducting structure in a well‐aerated middle ear. 1 , 2 , 3 Surgical technique is an important factor in the graft success rate. 4 , 5 Different materials and techniques have been developed for tympanoplasty.…”

“…Chronic otitis media (COM) surgery is common all over the world, especially in developing countries. The aim of COM surgery is the reconstruction of tympanic membrane (TM) perforation and the establishment of a sound‐conducting structure in a well‐aerated middle ear 1–3 . Surgical technique is an important factor in the graft success rate 4,5 .…”