Mesna in Otologic Surgery: Efficacy and Safety-A Scoping Review

Area of Science:

• Otolaryngology
• Surgical Innovation
• Pharmacology

Background:

• Mesna (Sodium 2-mercaptoethanesulfonate) is a known mucolytic and uroprotective agent.
• Its disulfide bond-breaking property is a novel application in otologic surgery.
• This property facilitates dissection of cholesteatoma and other adhesions.

Purpose of the Study:

• To evaluate the efficacy of Mesna in otologic surgeries.
• To assess the toxicity profile of Mesna in otologic applications.
• To review Mesna's use in treating cholesteatoma and other otologic conditions.

Main Methods:

• A comprehensive literature search was conducted across eight databases.
• Studies were included if they investigated Mesna in otology and reported efficacy or toxicity.
• PRISMA-ScR guidelines were followed for this systematic review.

Main Results:

• Eighteen studies (9 human, 9 animal) met the inclusion criteria.
• Mesna demonstrated effectiveness in cholesteatoma surgery, ossicular chain fixation, tympanic tube replacement, and adhesive otitis media.
• Concentrations ranging from 4% to 100% showed no significant toxicity in animal models or clinical research.

Conclusions:

• Mesna can be safely and effectively utilized in otologic surgical procedures.
• Further research is recommended to optimize Mesna's concentration, administration, and contact time.
• Quantifying Mesna's precise effects in otologic surgery requires additional investigation.