Use of Mesna in cholesteatoma surgery

Abstract

Cholesteatoma is a chronic benign ear lesion with invasive potential, which can lead to severe complications. The treatment is surgical, but complete removal is challenging and recurrence is common. Therefore, new techniques may be useful to facilitate the procedure. The aim of this study is to review the use of MESNA (2-sulphanylethanesulfonate sodium), a chemical agent with mucolytic and antioxidant properties, in terms of its effectiveness and safety in cholesteatoma surgery. A narrative review was performed including 22 preclinical and clinical studies based on the application of MESNA in cholesteatoma surgery. Current evidence suggests that MESNA can reduce the incidence and prevalence of residual cholesteatoma in both animal models and humans, without significant impact in complications. However, a potential association with meatoplasty stenosis has been observed. In conclusion, it has demonstrated a significant potential as a complement in cholesteatoma surgery by facilitating the removal of pathological tissue and safely reducing recurrence. Nevertheless, further studies are needed to optimize and confirm its ultimate utility in cholesteatoma surgery.