Surgical Solutions

Safe and Natural Protection Against Adhesions

Anika’s all-natural hyaluronic acid (HA)-based anti-adhesion products work to prevent or reduce post-surgical adhesions, a common complication after a variety of surgical procedures.

Hyalobarrier Gel /Hyalobarrier Gel Endo

Hyalobarrier® Gel and Hyalobarrier Gel Endo are sterile, transparent and highly viscous gels that form a barrier to prevent or reduce post-surgical adhesions in the abdomino-pelvic area. They are composed of highly purified, auto cross-linked polysaccharide (ACP®) of hyaluronic acid, one of the main components of human connective tissue and of epithelial and mesothelial tissues.

Hyalobarrier adheres to the tissue surface and to the abdominal wall, creating a physical antiadhesion barrier after surgery, which keeps the adjacent tissues separated during the healing process, protecting against adhesions. The anti-adhesion gel is then completely resorbed into the body over time. The devices have proven clinical safety and efficacy results in different clinical settings.1-14

Key Features & Benefits

  • Resorbable
  • Safe and effective against adhesion formation
  • Quick and easy application

Hyalobarrier is not approved for use in the United States.

ENT Solutions

Anika’s hyaluronic acid (HA)-based ENT products are composed of HYAFF®, an ester of hyaluronic acid, a naturally occurring constituent of the extracellular matrix. They act in the nasal/sinus and the middle ear/ external ear canal as space occupying dressing and/or stent, to separate mucosal surfaces and to help control minimal bleeding following surgery, and in otologic packing, as an adjunct to aid in the natural healing process. In contact with body fluids, they change into a viscous and transparent gel conforming to mucosal surfaces, and eventually dissolve or may be irrigated from the cavity. They have proven clinical safety and efficacy results in different clinical settings.15-33

Key Features & Benefits

  • Safe and effective
  • Resorbable

Anika products may not be available in all geographies. Product availability is subject to the regulatory clearances in individual markets. Please reach out to your local representative or Contact Us if you have questions about specific market approvals.

For complete product information, including indications, contraindications, warnings, and precautions, please refer to the Instructions for Use provided with the product or Contact Us for a copy.


Hyalobarrier gel/ Hyalobarrier gel endo

  1. Pellicano M, Bramante S, Cirillo D, Palomba S, Bifulco G, Zullo F, Nappi C. Effectiveness of autocrosslinked hyaluronic acid gel after laparoscopic myomectomy in infertile patients: a prospective, randomized, controlled study. Fertil Steril. 2003 Aug; 80(2):441-4.
  2. Acunzo G, Guida M, Pellicano M, Tommaselli GA, Di Spiezio Sardo A, Bifulco G, Cirillo D, Taylor A, Nappi C. Effectiveness of auto-cross-linked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic adhesiolysis:  a prospective, randomized, controlled study. Hum Reprod. 2003 Sep;18(9):1918-21.
  3. Carta G, Cerrone L, Iovenitti P. Postoperative adhesion prevention in gynecologic surgery with hyaluronic acid. Clin Exp Obstet Gynecol. 2004; 31(1):39-41.
  4. Guida M, Acunzo G, Di Spiezio Sardo A, Bifulco G, Piccoli R, Pellicano M, Cerrota G, Cirillo D, Nappi C. Effectiveness of auto-crosslinked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic surgery: a prospective, randomized, controlled study. Hum Reprod. 2004 Jun; 19(6):1461-4. Epub 2004 Apr 22.
  5. Pellicano M, Guida M, Bramante S, Acunzo G, Di Spiezio Sardo A, Tommaselli GA, Nappi C. Reproductive outcome after autocrosslinked hyaluronic acid gel application in infertile patients who underwent laparoscopic myomectomy. Fertil Steril. 2005 Feb; 83(2):498-500.
  6. Mais V, Bracco GL, Litta P, Gargiulo T, Melis GB. Reduction of postoperative adhesions with an auto-crosslinked hyaluronan gel in gynecological laparoscopic surgery: a blinded, controlled, randomized, multicenter study. Hum Reprod. 2006 May; 21(5):1248-54. Epub 2006 Jan 26.
  7. Mais V, Cirronis MG, Peiretti M, Ferrucci G, Cossu E, Melis GB Efficacy of auto-crosslinked hyaluronan gel for adhesion prevention in laparoscopy and hysteroscopy: a systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2012 Jan; 160(1):1-5. Epub 2011 Sep 25.
  8. Litta P, Pluchino N, Freschi L, Borgato S, Angioni S. Evaluation of adhesions after laparoscopic myomectomy using the Harmonic Ace and the auto-crosslinked hyaluronan gel vs Ringer’s lactate solution. Clin Exp Obstet Gynecol. 2013;40(2):210- 4.
  9. Bosteels J, Weyers S, Mol BW, D’Hooghe T. Anti-adhesion barrier gels following operative hysteroscopy for treating female infertility: a systematic review and meta-analysis. Gynecol Surg. 2014; 11:113-127. Epub 2014 Mar 14.
  10. Cheong Y, Bailey S, Forbes J. Randomized Controlled Trial of Hyalobarrier Versus No Hyalobarrier on the Ovulatory Status of Women with Periovarian Adhesions: A Pilot Study. Adv Ther. 2017 Jan;34(1):199-206.
  11. Hooker AB, de Leeuw R, van de Ven PM, Bakkum EA, Thurkow AL, Vogel NEA, van Vliet HAAM, Bongers MY, Emanuel MH, Verdonkschot AEM, Brölmann HAM, Huirne JAF. Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial. Fertil Steril. 2017 May;107(5):1223-1231. Epub 2017 Apr 6.
  12. Huang CY, Chang WH, Cheng M, Huang HY, Horng HC, Chen YJ, Lee WL, Wang PH. Crosslinked Hyaluronic Acid Gels for the Prevention of Intrauterine Adhesions after a Hysteroscopic Myomectomy in Women with Submucosal Myomas: A Prospective, Randomized, Controlled Trial. Life (Basel). 2020 May 15;10(5):67
  13. Hooker AB, de Leeuw RA, Twisk JWR, Brölmann HAM, Huirne JAF. Pregnancy and neonatal outcomes 42 months after application of hyaluronic acid gel following dilation and curettage for miscarriage in women who have experienced at least one previous curettage: follow-up of a randomized controlled trial. Fertil Steril. 2020 Sep;114(3):601-609
  14. Cheng M, Chang WH, Yang ST, Huang HY, Tsui KH, Chang CP, Lee WL, Wang PH. Efficacy of Applying Hyaluronic Acid Gels in the Primary Prevention of Intrauterine Adhesion after Hysteroscopic Myomectomy: A Meta-Analysis of Randomized Controlled Trials. Life (Basel). 2020 Nov 15;10(11):285


  1. Martini A, Morra B, Aimoni C, Radice M. Use of a hyaluronan-based biomembrane in the treatment of chronic cholesteatomatous otitis media. Am J Otol. 2000 Jul; 21(4):468-73.
  2. Saliba I. Hyaluronic acid fat graft myringoplasty: how we do it. Clin Otolaryngol. 2008 Dec; 33(6):610-4.
  3. Saliba I, Woods O. Hyaluronic acid fat graft myringoplasty: a minimally invasive technique. Laryngoscope. 2011 Feb;121(2):375-80. doi: 10.1002/lary.21365. Epub 2011 Jan 13.
  4. Saliba I, Froehlich P. Hyaluronic acid fat graft myringoplasty: an office-based technique adapted to children. Arch Otolaryngol Head Neck Surg. 2011 Dec; 137(12):1203-9.
  5. Saliba I, Knapik M, Froehlich P, Abela A Advantages of hyaluronic Acid fat graft myringoplasty over fat graft myringoplasty. Arch Otolaryngol Head Neck Surg. 2012 Oct 1; 138(10):950-5.
  6. Alzahrani M, Saliba I.Hyaluronic acid fat graft myringoplasty vs fat patch fat graft myringoplasty. Eur Arch Otorhinolaryngol. 2014 Mar 15. [Epub ahead of print]
  7. Gün T, Boztepe OF, Atan D., İkincioğulları A, Dere H. Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations. Int Adv Otol 2016; 12: 137-141
  8. Ballivet de Régloix S, Crambert A, Salf E, Maurin O, Pons Y, Clément P. Early Tympanoplasty Using a Synthetic Biomembrane for Military-Related Blast Induced Large Tympanic Membrane Perforation. Mil Med. 2018 Nov 1;183(11-12): e624-e627.
  9. Wong WK, Luu EH. What is the Role of Hyaluronic Acid Ester in Myringoplasty? Systematic Review and Meta-Analysis. Otol Neurotol. 2019 Aug;40(7):851-857.
  10. Tashjian M, Ruiz A, Dinwiddie J, Greenlee C, Wine T. Cost of closure: Comparing success and spending of fat graft myringoplasties with and without hyaluronic acid. Int J Pediatr Otorhinolaryngol . 2020 Aug;135: 110104. Epub 2020 May 24.
  11. Miller RS, Steward DL, Tami TA, Sillars MJ, Seiden AM, Shete M, Paskowski C, Welge J..The clinical effects of hyaluronic acid ester nasal dressing (Merogel) on intranasal wound healing after functional endoscopic sinus surgery. Otolaryngol Head Neck Surg, 2003. 128(6): p. 862-9
  12. Catalano PJ, Roffman EJ. Evaluation of middle meatal stenting after minimally invasive sinus techniques (MIST). Otolaryngol Head Neck Surg, 2003. 128 (6): p. 875
  13. Xu G, Chen HX, Wen WP, Shi JB, Li Y. Clinical evaluation of local application of Merogel after endoscopic sinus surgery. Zhonghua Er Bi Yan Hou Ke Za Zhi, 2003. 38(2): p. 95-7
  14. Franklin, J.H. and E.D. Wright, Randomized, controlled, study of absorbable nasal packing on outcomes of surgical treatment of rhinosinusitis with polyposis. Am J Rhinol, 2007. 21(2): p. 214-7
  15. Berlucchi M, Castelnuovo P, Vincenzi A, Morra B, Pasquini E. Endoscopic outcomes of resorbable nasal packing after functional endoscopic sinus surgery: a multicenter prospective randomized controlled study. Eur Arch Otorhinolaryngol. 2009 Jun; 266(6):839-45. Epub 2008 Oct 23
  16. Wu W, Cannon PS, Yan W, Tu Y, Selva D, Qu J. Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis. Eye (Lond). 2011 Jun; 25(6):746-53
  17. Song KJ, Lee HM, Lee EJ, Kwon JH, Jo KH, Kim KS. Anti-adhesive effect of a thermosensitive poloxamer applied after the removal of nasal packing in endoscopic sinus surgery: a randomised multicentre clinical trial. Clin Otolaryngol. 2013 Jun;38(3):225-30
  18. Qian Z, Tu Y, Xiao T, Wu W. A Lacrimal Sump Syndrome. With a Large Intranasal Ostium. J Craniofac Surg. 2015 Jul; 26 (5): e386-8
  19. Deng R, Fang Y, Shen J, Ou X, Liuyan W, Wan B, Yuan Y, Cheng X, Shu Y, Chen B. Effect of esterified hyaluronic acid as middle ear packing in tympanoplasty for adhesive otitis media. Acta Otolaryngol. 2018 Feb; 138 (2): 105-109. Epub 2017 Oct 26

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