title: The clinical application and efficacy of sodium hyaluronate-carboxymethylcellulose during tympanomastoid surgery.
abstract: OBJECTIVE
  To evaluate the anti-adhesive and anti-inflammatory effects of sodium hyaluronate-carboxymethylcellulose (HA-CMC) on postoperative hearing improvement and complications during tympanomastoid surgery.
  
  
  METHODS
  Prospective controlled clinical trial.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  These findings suggest that combined application of Gelfoam with HA-CMC may be beneficial in patients undergoing tympanomastoid surgery.
authors.affiliation: Department of Otolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. meniere@amc.seoul.kr
authors.forename: Joong Ho
authors.initials: JH
authors.lastname: Ahn
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Lim
authors.forename: Hye-Ran
authors.initials: HR
authors.lastname: Hong
mesh_terms: D002266:Carboxymethylcellulose Sodium / Q000494:pharmacology*; D004337:Drug Carriers / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology*; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D010033:Otitis Media / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D016037:Single-Blind Method; D000267:Tissue Adhesions; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*; D014433:Tympanoplasty / Q000379:methods*; D055675:Viscosupplements / Q000494:pharmacology
chemical_list: D004337:Drug Carriers; D055675:Viscosupplements; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium