Mastoid Obliteration Using S53P4 Bioactive Glass in Cholesteatoma Surgery: A 10-Year Single-Center Experience in 173 Adult Patients with Long-Term Magnetic Resonance Imaging Controlled Follow-up.
Otol Neurotol
; 43(10): 1181-1188, 2022 12 01.
Article
in En
| MEDLINE
| ID: mdl-36099589
ABSTRACT
OBJECTIVE:
To present the long-term outcomes of mastoid obliteration in cholesteatoma surgery using S53P4 bioactive glass (BAG) in an adult population. STUDYDESIGN:
Retrospective cohort study.SETTING:
Single-center study. PATIENTS All 173 adult patients who underwent primary or revision surgery for cholesteatoma with mastoid obliteration using S53P4 BAG with at least 1 year of follow-up including nonecho planar diffusion-weighted magnetic resonance imaging (MRI) (non-EP DWI MRI) and/or second-look surgery to evaluate recidivism. Both canal wall up (CWU) and canal wall down (CWD) procedures were included.INTERVENTIONS:
Patients underwent CWU or CWD mastoidectomy using S53P4 BAG. MAIN OUTCOME ANDMEASURES:
Cholesteatoma recidivism, postoperative complications, Merchant grade, hearing outcome.RESULTS:
Cholesteatoma recidivism was assessed by MRI in 97% of all cases and second-look surgery look surgery in 3% of cases. After a mean follow-up period of 53 months, cholesteatoma recidivism was seen in 10% of the cases (n = 18). Using the Kaplan-Meier curve to extrapolate, a 5-year recidivism rate of 12% was estimated. Only minor complications occurred, all resolving spontaneously or after minor treatment. Merchant grade of 0 to 1 was achieved 95% of the patients, no persistently wet ears were observed. Closure of the air-bone gap within 20 dB was possible in 32%.CONCLUSION:
In this long-term (up to 10 yr) follow-up study, we demonstrated the safety of S53P4 BAG. Minimal and only minor postoperative complications were observed. The effectiveness of BAG was indicated by the low rate of recidivism, even when using non-EP DWI MRI, a sensitive and specific noninvasive technique to detect cholesteatoma recidivism.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cholesteatoma, Middle Ear
/
Mastoidectomy
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
Otol Neurotol
Journal subject:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Year:
2022
Document type:
Article