A comparative study between haemocoagulase and adrenaline in type 1 tympanoplasty

INTRODUCTION: Haemostasis is a critical component of ear surgeries, which can be achieved by topical methods including simple manual pressure with gauze or cotton balls soaked with adrenaline, administration of haemostatic agents or vasoconstrictive materials. OBJECTIVE: To compare efficacy of haemocoagulase and adrenaline in attaining middle ear haemostasis in type - 1 tympanoplasty with or without cortical mastoidectomy. To study the effect of haemocoagulase in middle ear. MATERIALS AND METHOD: This is a prospective comparative study conducted in a tertiary care hospital from January 2013 to June 2014. Patients undergoing type 1 tympanoplasty with or without cortical mastoidectomy were divided into two groups. In group A (50 cases), cotton balls soaked in 2 ml Haemocoagulase was used and in group B (50 cases) cotton balls soaked in 2 ml Adrenaline (1:1000 dilution) was used for middle ear haemostasis. The efficacy of haemocoagulase and adrenaline was compared. RESULTS: The mean number of cotton balls used in haemocoagulase group in cases with congested middle ear mucosa was more than those used in the adrenaline group. Duration of surgery was more in haemocoagulase group (65 min) with congested mucosa, compared to adrenaline group (50 min). The mean blood pressure was significantly higher in adrenaline group compared to haemocoagulase group. Postoperative hearing improvement in both groups showed no significant difference with p value 0.694. CONCLUSIONS: Adrenaline is a better middle ear haemostatic than haemocoagulase. However, haemocoagulase can safely be used in patients with hypertension.