Is gelfoam sealing necessary in stapes surgery?

Abstract

Background

Sealing the oval window around the piston after fenestration with Gelfoam^® is a common practice in stapes surgery for otosclerosis.

Objectives

To analyse the effect of using or not using Gelfoam^® as a sealing material.

Methods

A retrospective study was performed on 418 patients who underwent stapes surgery from 2013 until 2019. Data were collected from medical records in a tertiary centre. 215 cases in the Gelfoam group and 203 cases in the control group without sealing were included. The main comparisons were made between these two groups in terms of vestibular (primary outcome) and audiological outcomes and complications.

Results

The patients’ mean age was 47 years with a mean follow up of 50 months and a female predominance (65.6%, p = .049). There was no significant difference in terms of postoperative vertigo (11.6% vs 8.4%) or audiological outcomes in between Gelfoam and control group respectively. The average postoperative air-bone gap in the Gelfoam group was 4.6 dB vs. 5.3 dB in the control group (p = .634).

Conclusion and significance

No difference were identified in vestibular or audiological outcomes during stapes surgery when using or not using Gelfoam^® in the middle ear.

Chinese abstract

背景：开窗手术后, 用GelfoamVR密封活塞周围的椭圆形窗口是用于骨硬化性镫骨手术的一种常见做法。

目的：分析使用或不使用GelfoamVR作为密封材料的效果。

方法：对2013年至2019年接受镫骨手术的418例患者进行了回顾性研究。数据来自三级中心的医疗记录。包括Gelfoam组的215例和无密封对照组的203例。这两组在前庭（主要结果）和听力结果及并发症方面进行了比较。

结果：患者平均年龄为47岁, 平均随访50个月, 女性占多数（65.6％, p¼.049）。 Gelfoam组和对照组之间的术后眩晕（11.6％比8.4％）或听觉方面无显着差异。 Gelfoam组的平均术后气骨间隙为4.6 dB, 而对照组为5.3 dB（p¼.634）。

结论和意义：在中耳使用或不使用GelfoamVR的镫骨手术的情况下, 前庭的或听力的结果均无差异。

Keywords:

• Gelfoam
• fenestration
• perilymphatic fistula
• fibrosis
• toxicity

Acknowledgments

The statistical analyses, editing and translation of this article were supported by the American Journal Experts. The authors also wish to thank the first reviewer Sonia Duret.

Disclosure statement

No potential conflict of interest was reported by the author(s).