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

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.

– 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

– Main Outcome Measure(s)
: post-operative visits, post-operative healing and complications including infection, drainage, granulation tissue, and wound healing
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.

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.