New method for packing the external auditory canal, middle ear space, and mastoid cavities after otologic surgery

Since its introduction in 1945, an absorbable gelatin sponge, Gelfoam, has long been a staple used for packing in otologic surgery. The present method commonly employed at the University of Manitoba teaching hospitals requires that operating room nurses carefully prepare extremely small pieces of both compressed and noncompressed Gelfoam. These pieces are then selectively soaked in an antibiotic solution and carefully placed, one by one, into the appropriate position. We describe a new paste preparation of Gelfoam powder, Thrombostat, acetic acid, and Bacitracin ointment, which can very quickly be injected from a syringe into the operated cavity. Our preliminary study indicates that this preparation reduces operating time, while making the process of packing easier for the surgeon. In addition, it ensures a more evenly packed cavity while still fulfilling the requirements of middle ear packing. Postoperatively, it was found to be easier to debride from the operative cavity in the office, decreasing patient discomfort and procedure time. Reported below is a preliminary clinical patient series report comparing this new method to the old method.