A comparative study between haemocoagulase and adrenaline in type 1 tympanoplasty

Abstract

Introduction Haemostasis is a critical component of ear surgeries, which can be achieved by topical methods including simple manual pressure with gauze or cotton balls soaked with adrenaline, administration of haemostatic agents or vasoconstrictive materials. Objective To compare efficacy of haemocoagulase and adrenaline in attaining middle ear haemostasis in type - 1 tympanoplasty with or without cortical mastoidectomy. To study the effect of haemocoagulase in middle ear. Materials and method This is a prospective comparative study conducted in a tertiary care hospital from January 2013 to June 2014. Patients undergoing type 1 tympanoplasty with or without cortical mastoidectomy were divided into two groups. In group A (50 cases), cotton balls soaked in 2 ml Haemocoagulase was used and in group B (50 cases) cotton balls soaked in 2 ml Adrenaline (1:1000 dilution) was used for middle ear haemostasis. The efficacy of haemocoagulase and adrenaline was compared. Results The mean number of cotton balls used in haemocoagulase group in cases with congested middle ear mucosa was more than those used in the adrenaline group. Duration of surgery was more in haemocoagulase group (65 min) with congested mucosa, compared to adrenaline group (50 min). The mean blood pressure was significantly higher in adrenaline group compared to haemocoagulase group. Postoperative hearing improvement in both groups showed no significant difference with p value 0.694. Conclusions Adrenaline is a better middle ear haemostatic than haemocoagulase. However, haemocoagulase can safely be used in patients with hypertension.

Long-term results of type I tympanoplasty with perichondrium reinforced cartilage palisade vs temporalis fascia for large perforations: A retrospective study

“…Chronic otitis media is a long-standing middle ear infection that can lead to ear discharge and permanent changes in the tympanic membrane ( Chemmangath et al., 2019 ). Treatment options include ear toileting, topical or systemic antibiotics, or surgery to eradicate disease and close the perforation ( Dornhoffer, 1997 ).…”

Efficacy of Topical Epinephrine in Tympanoplasty

“…Resource constraints prevented us from evaluating the efficacy of more dilute TE concentrations, but this should be done. TE concentrations used in ear surgery range from as high as 1:1,000 21,22 to as low as 1:200,000 23 …”

“…Resource constraints prevented us from evaluating the efficacy of more dilute TE concentrations, but this should be done. TE concentrations used in ear surgery range from as high as 1:1,000 21,22 to as low as 1:200,000. 23 One of the most serious drivers for reducing the TE concentration is the potential for life-threatening complications with inadvertent soft tissue infiltration of TE.…”

Effect of Topic Epinephrine on Opioid Consumption in Ear Surgery

“…Even these very low concentrations can impair inner ear perfusion though not causing any relevant clinical complications [3,4]. Besides that epinephrine can be applied superficially on the bleeding tissue in a high concentration (1:1.000) to diminish or stop bleeding in situations when surgical hemostatic methods fail or are technically not feasible, such es endoscopic or microscopic ear surgery [5][6][7][8]. It is believed that this may have an effect on local circulation as well as on pain perception, this phenomenon has not been investigated yet.…”