KBB-Forum 2020 , Cilt 19, Sayı 4

INVESTIGATION OF THE EFFECTS OF EXTERNAL EAR PACKING MATERIALS ON HEALING AFTER CHRONIC OTITIS MEDIA SURGERY: A RANDOMIZED PROSPECTIVE CONTROLLED STUDY

Dr. Akif İŞLEK1, Dr. Mustafa Koray BALCI2, Dr. İbrahim ALADAĞ2, Dr. Ayşegül AKSOY GÖKMEN3
1Nusaybin Devlet Hastanesi, KBB, Mardin, Türkiye
2İzmir Katip Çelebi Üniversitesi, Atatürk Eğitim Araştırma Hastanesi, KBB, İzmir, Türkiye
3İzmir Katip Çelebi Üniversitesi, Atatürk Eğitim Araştırma Hastanesi, Tıbbi Mikrobiyoloji, İzmir, Türkiye
Objective: To investigate the effects of three different external ear canal (EEC) wick materials used after chronic otitis media (COM) surgery on postoperative EEC healing and bacterial colonization.

Patients and Method: The study was designed prospectively. Patients who underwent type-1 tympanoplasty were randomly included in three study groups (sponge, merocel, and gas strip) according to the ear wick material. A sterile swab sample was collected under the oto-microscope just before the operation and after removing the EEC wick on the seventh day after the operation. Wound healing was evaluated with oto-microscope after three weeks from the operation.

Results: Twenty-four (33.8%) patients were included in the merocel group, 24 (33.8%) patients in the sponge group, and 23 (32.4%) patients in the gas strip group. ECC flaps of 17 patients were not completely healed at the end of the third week after the surgery. While flap healing was significantly better in the sponge group (p = 0.022), a significantly higher defect rate was found in the gas strip group (p = 0.002). The shortest time for EEC flap recovery was in the sponge group with 20.6 ± 1.9 days. The same duration was 29.0 ± 3.2 days in the gas strip group as the longest (p <0.001). An average of 3.66 (OR) fold increase in the rate of bacterial reproduction in postoperatively taken swabs compared to preoperative samples was found statistically significant in merocel group. (p = 0.031, McNemar test).

Conclusion: Postoperative positive EEC cultures are not affected by ear wick material, but merocel ear wick is associated with increased bacterial colonization. Wound healing was found to be worse and longer in the gas strip group, while the best results were obtained in the sponge group. Keywords : External Ear Wick; Gas strip; Granulation; Merocel; Stenosis; Spongostan