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Fibrin Sealant as an Alternative to External Ear Canal Packing in Endoscopic Ear Surgeries – World Congress on Endoscopic Ear Surgery

Fibrin Sealant as an Alternative to External Ear Canal Packing in Endoscopic Ear Surgeries

By June 7, 2019

Vaisbuch, Y.1; Sayyid, Zahra1; Sajjadi, A.2; Sajjadi, H.1
1 Stanford University Department of Otolaryngology-HNS
2 Creighton University School of Medicine

Introduction:
The aim of this study was to describe a new technique for external ear canal packing using fibrin sealant injection under an endoscopic view in otological surgeries. The surgical technique consists  of infusion of 1-2 ml of fibrin sealant with duploject system  (“Tisseel”, BAXTER 1501236) filling the entire ear canal.

Methods:
– Study Design: retrospective case review
– Setting: private and tertiary referral centers
– Patients: 155 cases that were treated by a single otologist between 2014-2018; 85% male; average age at time of surgery: 57.1 years
– Intervention(s):  endoscopic tympanoplasty with or without mastoidectomy

Discussion:
– Main Outcome Measure(s)
: post-operative visits, post-operative healing and complications including infection, drainage, granulation tissue, and wound healing
Results:
First postop visit was at 6 weeks when most ear canals were clear and there was seldom any need to remove any remnant of the Tisseel. No post-operative complications related to the external ear canal Tisseel use were noted. Specifically, no canal infections and no poor healing of the canal incisions were detected.

Conclusion:
The common practice of sponge packing the external ear canal at the end of the otological surgery necessitates removal, which can be uncomfortable. Use of the fibrin sealant is a safe alternative technique improving the comfort of the patients by reducing post-operative canal sponge packing. Consequently, this also eliminates the need for the early post-operative visit to remove packing, reducing healthcare cost.