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Evaluation of Esterified Hyaluronic Acid as Middle Ear–Packing Material
Geming Li, MD;
Joseph G. Feghali, MD;
Elizabeth Dinces, MD;
John McElveen, MD;
Thomas R. Van De Water, PhD
Arch Otolaryngol Head Neck Surg. 2001;127:534-539.
Objective To evaluate the efficacy of esterified hyaluronic acid (MeroGel) as
a middle ear (ME)–packing material.
Design Randomized controlled trial.
Material Twenty-four guinea pigs.
Intervention Group 1, MeroGel-treated animals (n = 10), bilateral wounding of ME
mucosa with 5 of the animals receiving the MeroGel packing in the left ME
and 5 of the animals receiving MeroGel in the right ME; group 2, absorbable
gelatin sponge–treated animals (n = 10), with the same experimental
protocol as in group 1 except that the absorbable gelatin sponge was the packing
material; group 3, untreated animals (n = 4), unilateral wounding of the left
ME mucosa in 2 animals and in 2 animals in the right ME, with no packing material.
Auditory brainstem recordings were performed for all groups before the ME
operation and 5 days and 6 weeks after the operation.
Results Auditory brainstem response recordings at postoperative day 5 showed
that all ears with ME packing had hearing losses in the frequency range of
500 to 4000 Hz. The recovery of hearing acuity at postoperative week 6 was
significantly better in group 1 (MeroGel-treated) guinea pigs compared with
group 2 (the absorbable gelatin sponge–treated) animals. In group 2
animals, 20% of the packing material remained in the ME cavities and new bone
formation was observed, while in group 1 animals, there was less packing material
in the ME and no formation of new bone.
Conclusions MeroGel is a nonototoxic packing material with a high level of biocompatibility
for ME mucosa; it is an effective supportive material following ME surgery
and is easily expelled from the ME cavity.
From the Departments of Otolaryngology (Drs Li and Van De Water) and
Neuroscience (Dr Van De Water), Albert Einstein College of Medicine, Bronx,
NY; Department of Otolaryngology, Montefiore Medical Center, Bronx (Drs Feghali,
Dinces, and Van De Water); Department of Otolaryngology, Beth Israel Medical
Center, New York, NY (Dr Feghali); and Carolina Ear and Hearing Clinic, Raleigh,
NC (Dr McElveen).
Corresponding author and reprints: Thomas R. Van De Water, PhD, Department
of Otolaryngology, Albert Einstein College of Medicine, 1410 Pelham Pkwy S,
Kennedy Center, Room 302, Bronx, NY 10461 (e-mail: vandewat{at}aecom.yu.edu).
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