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A ‘chemical help’ in middle-ear surgery? A systematic review on sodium 2-mercaptoethanesulfonate

Published online by Cambridge University Press:  05 July 2021

A Moffa ,
V Fiore ,
L Sabatino ,
M Cassano ,
M Tarabichi ,
M Kapadia ,
V Rinaldi  and
M Casale
A Moffa*
Affiliation:
Unit of Otolaryngology – Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy Unit of Otolaryngology, University of Foggia, Italy
V Fiore
Affiliation:
Unit of Otolaryngology, University of Foggia, Italy
L Sabatino
Affiliation:
Unit of Otolaryngology – Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
M Cassano
Affiliation:
Unit of Otolaryngology, University of Foggia, Italy
M Tarabichi
Affiliation:
Department of Otolaryngology, Tarabichi Stammberger Ear Sinus Institute, Dubai, United Arab Emirates Department of Otolaryngology, American Hospital Dubai, United Arab Emirates
M Kapadia
Affiliation:
Department of Otolaryngology, Tarabichi Stammberger Ear Sinus Institute, Dubai, United Arab Emirates
V Rinaldi
Affiliation:
Unit of Otolaryngology – Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
M Casale
Affiliation:
Unit of Otolaryngology – Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
*
Author for correspondence: Dr Antonio Moffa, Unit of Otolaryngology – Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Via Álvaro del Portillo, Rome 21-00128, Italy E-mail: a.moffa@unicampus.it Fax: +39 06 22 54 11
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Abstract

Objective

Sodium 2-mercaptoethanesulfonate (Mesna) has been proposed as a chemical aid in any surgical procedure, including cholesteatoma surgery. This review investigated the benefits and safety of Mesna during surgical management of cholesteatoma and adhesive otitis media.

Method

A systematic literature review was performed to identify clinical studies evaluating topical Mesna application during ear surgery (cholesteatoma or atelectasis). A qualitative analysis based on data extracted was conducted.

Results

From 27 articles, 5 retrospective studies were selected for a full analysis for a total of 607 patients (aged 5 to 72 years). Three studies evaluated cholesteatoma recidivism after Mesna application during cholesteatoma surgery, one study evaluated the surgical success rate of Mesna application for the treatment of atelectatic ears and adhesive otitis media, and one study evaluated potential ototoxicity of Mesna during cholesteatoma surgery. All the studies showed overall improvement in recurrence and residual cholesteatoma disease after Mesna application during surgery. Sensorineural hearing loss was not encountered after Mesna application.

Conclusion

Mesna application in cholesteatoma surgery could represent a valid and safe support tool during surgical treatment carried out both with microscopy and endoscopy. More studies are required to confirm these promising results.

Keywords

Sodium 2-MercaptoethanesulfonateMesnaTympanoplastyMastoidectomyDissection
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 8 , August 2021 , pp. 660 - 667
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr A Moffa takes responsibility for the integrity of the content of the paper

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