Mid-term outcomes of mastoid obliteration with biological hydroxyapatite versus bioglass: a radiological and clinical study.
Eur Arch Otorhinolaryngol
; 279(9): 4379-4388, 2022 Sep.
Article
em En
| MEDLINE
| ID: mdl-35038026
ABSTRACT
PURPOSE:
Radiological assessment of osseointegration of mastoid grafts biological hydroxyapatite (Bio-Oss®) (BHA) versus bioglass S53P4 (Bonalive®) (BG).METHODS:
Retrospective (10 ± 4 months post-surgery) monocentric high resolution computed tomography (CT) scan assessment (November 2018 and October 2020) by two independent radiologists (R1, R2), blinded to patient allocation. All patients who had undergone a total mastoid obliteration were eligible. Excluded complications namely otological acute or chronic infections, unbalanced metabolic disease, long-term cortico-steroid therapy, auto-immune disease, history of allergy to grafting materials and post-surgery CT scan in other centers (n = 8). PRIMARYOUTCOMES:
the ratio between two regions of interests (ROI) (graft to otic capsule). SECONDARYOUTCOMES:
resorption of mastoid grafts and assessment of clinical tolerance.RESULTS:
Included 21 patients (mean age 29 ± 21 years; 5 females, 16 males). Significantly higher osseointegration for BHA vs. BG (R1 p = 0.043; R2 p = 0.004); almost perfect inter-reader agreement k = 0.922). The ROI ratios for BHA and BG to that of the otic capsule were 0.57 ± 0.11 (R1) and 0.59 ± 0.14 (R2); 0.43 ± 0.11 (R1) and 0.43 ± 0.08 (R2), respectively. Density increased significantly by 399 ± 261 Hounsfield units (HU) (p = 0.008) and decreased by 464 ± 161 HU (p < 0.001) for BHA vs. BG. Resorption rates were 24.1 ± 21.0% and 66.7 ± 15.1% (p = 0.076), respectively. No significant difference in clinical tolerance was observed.CONCLUSION:
Post-operative CT scan of mastoid obliteration seems reliable in assessment of biomaterial graft's mid-term feasibility and stability BHA seems to provide a more optimal osseointegration versus BG with no significant differences in graft resorption and clinical tolerance.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Colesteatoma da Orelha Média
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Processo Mastoide
Tipo de estudo:
Observational_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article