Intraoperative and Postoperative Advantages of two Absorbable Materials for Supporting Graft in Endoscopic Tympanoplasty: Oxidized Regenerated Cellulose (Surgicel ® ) Over Gelatin Sponge (Spongostan ® )

Abstract

Objective:

To compare the intraoperative and postoperative outcomes of using oxidized regenerated cellulose (Surgicel^®) versus absorbable gelatin sponge (Spongostan^®) for supporting graft material in endoscopic tympanoplasty.

Methods:

We retrospectively analyzed 92 patients who underwent endoscopic type 1 tympanoplasty between 2020 and 2024. Patients were divided into 2 groups based on the supporting graft material used: 47 received Surgicel^® and 45 received Spongostan^®. Primary outcome measures included intraoperative hemostasis quality, duration of graft placement, postoperative graft success, graft lateralization, and hearing outcomes at 6 and 12 months.

Results:

Hemostasis during graft placement was better in the Surgicel^® group (P = .017), and shorter graft placement duration was observed (P = .047). At ≥ 6 months, graft success rates were comparable between the groups (89.4% for Surgicel^® vs 82.2% for Spongostan^®; P = .380). However, graft lateralization was significantly less frequent in the Surgicel^® group (2.1%) compared to the Spongostan^® group (15.6%; P = .029). While the Spongostan^® group showed significantly better hearing results at 6 months (mean ABG 16.9 dB vs 28.6 dB; P < .001), hearing outcomes were similar by 12 months.

Conclusion:

Both Spongostan^® and Surgicel^® are effective supporting graft materials in endoscopic tympanoplasty. However, Surgicel^® was associated with certain intraoperative advantages, including superior hemostasis and shorter operative time, along with a significantly lower risk of postoperative graft lateralization. These benefits suggest Surgicel^® may be a preferable option for enhancing surgical efficiency and optimizing outcomes in endoscopic ear surgery.