The assesment of intraoperative use of mesna in canal wall-up cholesteatoma surgery – preliminary report

• Authors: Marta Pietraszek , Anna Bartochowska , Małgorzata Wierzbicka , Wojciech Gawęcki

Abstracts

PL

Introduction: Surgery is still the method of choice in the chronic otitis media with cholesteatoma. Except of some specific clinical situations, classic canal wall up technique (CWU), remains a gold standard as a primary treatment in most departments. Unfortunately, the risk of recurrence in such an approach is estimated at 9 to even 70%. This fact prompts researchers to look for the ways to reduce that unfavourable statistics. One of the recognized methods supporting the removal of cholesteatoma is the intraoperative use of mesna (sodium 2-mercaptoethanesulfonate). This synthetic sulphur compound disrupts disulfide bridges in polypeptide chains, thanks to which it facilitates matrix preparation. Objective: To evaluate the effect of intraoperative use of mesna on the treatment outcomes in patients with chronic otitis media with cholesteatoma operated by means of canal wall up technique (CWU). Material and methods: 459 surgical reports of patients with middle ear cholesteatoma were analyzed. 52 adult patients with no history of previous ear surgery operated by means of CWU technique by the same experienced otosurgeon with all follow-up data available were included into the study. 26 were operated on with the use of mesna (mesna group) and 26 by means of classic CWU technique (control / no-mesna group). There were 28 women and 24 men with the mean age of 41 years. Main Outcome Measure(s): Postoperative hearing results and cholesteatoma recidivism rate. Results: Overall recidivism rate was 21.15 %. It was higher in no-mesna (26.9%) than in mesna group (15.4%) - although the outcomes were better in mesna group, the difference was not statistically significant (p=0.49715). Hearing gain was better in mesna than in no-mesna group (10 dB vs 7 dB), but the difference was not statistically significant (p=0.20089). Conclusions: The results of the study show that mesna improves treatment outcomes in cholesteatoma surgery. Its intraoperative topical application is an effective and safe way of reducing recidivism rates in patients with cholesteatoma. Further study with the analysis of the larger group of patients is needed to prove it statistically.

Keywords

PL

chronic otitis media; cholesteatoma; surgery; mesna; chemically assisted tissue dissection

• Publisher: Index Copernicus International
• Journal: Polish Journal of Otolaryngology
• Year: 2023
• Volume: 77
• Issue: 4
• Pages: 1-6

Dates

published

2023

Contributors

author

Marta Pietraszek

• Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland
• Doctoral School, Poznan University of Medical Sciences, Poznan, Poland

• https://orcid.org/0000000189033420

author

Anna Bartochowska

• Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland

• https://orcid.org/0000000178621411

author

Małgorzata Wierzbicka

• Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland

• https://orcid.org/0000000300066352

author

Wojciech Gawęcki

• Department of Otolaryngology, Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland

• https://orcid.org/0000000261749758

Identifiers

DOI

10.5604/01.3001.0016.3415

Biblioteka Nauki

58713905