Clinical efficacy of outpatient MESNA application in the control of persistent otorrhea following canal wall down mastoidectomy

• Grant number: 24/02629-8
• Support Opportunities: Regular Research Grants
• Start date: July 01, 2024
• End date: June 30, 2026
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Jose Ricardo Gurgel Testa
• Grantee: Jose Ricardo Gurgel Testa
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated researchers: Adriana Perez Ferreira Neto

Abstract

INTRODUCTION: Canal wall down mastoidectomy, as a form of treatment for acquired cholesteatoma, aims to ensure an ear without otorrhea and free from recurrence. However, some patients have persistent otorrhea after surgery. Possible causes for the maintenance of otorrhea include incomplete cholesteatoma removal and/or presence of biofilm in the ear. Sodium 2-mercaptoethanesulfonate (MESNA) is a medication with the potential to facilitate cholesteatoma dissection and to disaggregate the biofilm of cholesteatoma fragments. OBJECTIVES: To verify if the outpatient application of MESNA allows a better clinical control of otorrhea and if in vitro promotes the disaggregation of the biofilm in patients with persistent otorrhea following canal wall down mastoidectomy. METHODS: Double-blind randomized clinical trial to be carried out at the Otorhinolaryngology outpatient clinic and at the Especial Clinical Microbiology Laboratory/Alerta of Universidade Federal de São Paulo (UNIFESP). Participants will be patients with persistent otorrhea previously submitted to canal wall down mastoidectomy. MESNA or placebo will be applied to the patients mastoid cavity to verify if the otorrhea clinically improves. A sample of the otorrhea will be collected to verify the presence of biofilm and if its conformation changes with the use of MESNA in vitro. (AU)