Use of Mesna in the treatment of ossicular chain fixation related to tympanosclerosis; prospective, clinical study

Abstract

Objective: Mesna is a thiol compound effective in the connective tissue, which is used for its chemical dissector, mucolytic, mucosal damage preventive and antioxidant effects. The aim of this study was to investigate Mesna's effects in easy dissection in type 4 tympanosclerosis cases and in the prevention of formation of new sclerotic plaques.

Methods: 11 patients were included in the study. All patients were in the Wielinga Kerr type 4 class of tympanosclerosis. All patients were administered a 100% concentration of Mesna in the middle ear during tympanosclerosis surgery. All patients underwent audiological evaluation before and 20 months after the operation. Air-conduction thresholds, bone-conduction thresholds and air-bone difference were statistically compared.

Results: The patients were followed-up for a mean 20.48 +/- 2.37 months. The mean preoperative air-conduction threshold of the patients was 58.09 +/- 9.73 dB and the mean postoperative air-conduction threshold was 34.63 +/- 15.46 dB and there was a significant difference. The mean preoperative bone-conduction threshold of the patients was 16.27 +/- 5.47 dB and the mean postoperative bone-conduction threshold was 14.72 +/- 6.11 dB and there was a significant difference. The mean preoperative air-bone gap of the patients was 41.81 +/- 10.51, and the mean postoperative air-bone gap was 19.90 +/- 12.48, and the difference was statistically significant.

Conclusion: Mesna prevented hearing loss related to type 4 tympanosclerosis and prevented the formation of new sclerotic structures in our follow-up period. We believe that this effect is due to the chemical dissector and antioxidant effects of Mesna.