Behaviour of Absorbable Gelatine Sponge in the Animal Middle Ear

To pack or not to pack? A contemporary review of middle ear packing agents

“…Gelfoam has many desirable properties such as non‐antigenicity, non‐toxicity, biocompatibility, and ease of handling 13, 44. Importantly, Gelfoam is well tolerated,45 with little abnormality found in the ME cavity with intact mucosa,4, 46 and also provides reasonable hemostasis44, 47 whether the Gelfoam is dry or wet 38. The degradation of Gelfoam was found to be within 2 to 9 weeks8, 38, 48, 49 and is quicker with intact ME mucosa8 and when the ME is lightly packed 38.…”

“…Pioneered by Correl and Wise in 1945,13 Gelfoam (absorbable gelatin sponge) is manufactured from denatured porcine skin. Initially treated as an absorbable hemostatic device in neurosurgery,38 Gelfoam is used extensively in otology as TM scaffolds,3, 39, 40 supportive materials for TM and ossicular grafts,4 eustachian tube plugs,41 oval window sealant,42, 43 and to repair skull base wound defects 38…”

“…Importantly, Gelfoam is well tolerated,45 with little abnormality found in the ME cavity with intact mucosa,4, 46 and also provides reasonable hemostasis44, 47 whether the Gelfoam is dry or wet 38. The degradation of Gelfoam was found to be within 2 to 9 weeks8, 38, 48, 49 and is quicker with intact ME mucosa8 and when the ME is lightly packed 38. The elimination of Gelfoam was initially thought to be by the eustachian tube,49 but was later found to be through phagocytosis 13, 38, 45…”

“…The degradation of Gelfoam was found to be within 2 to 9 weeks8, 38, 48, 49 and is quicker with intact ME mucosa8 and when the ME is lightly packed 38. The elimination of Gelfoam was initially thought to be by the eustachian tube,49 but was later found to be through phagocytosis 13, 38, 45…”

The clinical application and efficacy of sodium hyaluronate–carboxymethylcellulose during tympanomastoid surgery

“…The ideal packing material for middle‐ear reconstruction should be 1) sufficiently rigid to support the reconstructed TM, keeping it from drooping over the promontory; 2) biocompatible, allowing it to be absorbed after a sufficient period of time without leaving any foreign body that could induce recurrent infections; 3) nontoxic and nonallergenic, with minimum possibility of rejection; and 4) readily available 6. Gelfoam, an absorbable gelatin sponge initially developed as an absorbable hemostatic device in neurosurgery,18 has been used extensively in otologic surgery as supporting materials for TM and ossicular grafts, eustachian tube plugs, oval window sealant, and to repair skull base wound defects 4…”