[Utility of bone replacement material in cochlear implant, skull base and sinus surgery: our experience]. / Utilidad del material sustitutivo óseo en la cirugía del implante coclear, base de cráneo y senos paranasales: nuestra experiencia.

INTRODUCTION: To solve certain problems that arise in cochlear implant, sinus and skull base surgery, the use of bone cement (PolyBone®) has been introduced in our department. With the goal of making use of surgical bone cements, combining bone growth factors and polyphosphates has allowed the study of these biological materials. MATERIALS AND RESULTS: We present a total of 28 patients aged between 2 and 69 years (mean age of 29.2 years) in whom PolyBone® has been used as an additional therapeutic tool in the ENT surgical area. Complications occurred in 2 patients (7.4%). One was minor, solved with conservative treatment; one was a major complication that required surgery to extract the material and remove the implant. In the other 26 patients (92.6%), excellent results were achieved. CONCLUSIONS: Different autogenous and alloplastic materials are of great utility for fistula management, cavity filling or sinus obliteration, among other uses. The surgeon must understand their biological properties, fundamental characteristics, production technique and potential surgical applications to be able to prevent future complications. Among these materials, bone cement (PolyBone®) is an effective alternative that should be considered in surgical management of ENT pathology.

Cierre de una fístula oroantral usando cemento óseo y un colgajo de mucosa yugal / Closure of an oroantral fistula using bone cement and a jugal mucosa flap

Una fístula oroantral es una solución de continuidad patológica entre el seno maxilar y la cavidad oral, producida frecuentemente tras una extracción dentaria, en la mayoría de los casos, del primer o segundo molar. El síntoma más común que provoca es una sinusitis aguda, que evolucionará a la cronicidad si la fístula permanece. El diagnóstico se realiza mediante endoscopia transalveolar, ortopantografía o tomografía computarizada dental. Su cierre quirúrgico es necesario cuando la fístula tiene más de 3 mm, o no sella por sí misma en 3 semanas. Existen, para ello, varias técnicas, usando distintos materiales y colgajos, cuyo fin es ocluir, tanto el defecto óseo, como el mucoso, para solucionar así a la vez la fístula y el problema sinusal(AU)

The oroantral fistula is a solution of pathological continuity between the maxillary sinus and the oral cavity, frequently produced after a teeth extraction in most of cases of the first or second molars. The commonest symptom provoked is an acute sinusitis evolving to chronicity if the fistula remains. The diagnosis is made by transalveolar, orthopantography or dental computerized tomography. Its surgical closure is necessary when the fistula has more than 3 mm or not seal by itself in three weeks. For it, there are some techniques using different materials and flaps where its objective is to occlude the bone defect as well as the mucous one thus solving the fistula and the sinus problem(AU)