![]() ![]() In more recent years, obliteration of the created mastoid cavity has gained in popularity, especially since the development of the non–echo-planar diffusion-weighted magnetic resonance imaging (non-EP DWI MRI) to detect cholesteatoma recidivism ( 1–3). The two main surgical procedures available for treatment of cholesteatoma are canal wall up (CWU), with preservation of the posterior wall of the external ear canal, and canal wall down (CWD), both in combination with a mastoidectomy. 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.Ĭholesteatoma is a challenging disease involving the middle ear and mastoid, based on intrusion of stratified squamous epithelium, which can lead to the destruction of the ossicular chain and inner ear structures. Minimal and only minor postoperative complications were observed. In this long-term (up to 10 yr) follow-up study, we demonstrated the safety of S53P4 BAG. Closure of the air-bone gap within 20 dB was possible in 32%. Merchant grade of 0 to 1 was achieved 95% of the patients, no persistently wet ears were observed. Only minor complications occurred, all resolving spontaneously or after minor treatment. Using the Kaplan-Meier curve to extrapolate, a 5-year recidivism rate of 12% was estimated. After a mean follow-up period of 53 months, cholesteatoma recidivism was seen in 10% of the cases (n = 18). ![]() ResultsĬholesteatoma recidivism was assessed by MRI in 97% of all cases and second-look surgery look surgery in 3% of cases. Main Outcome and MeasuresĬholesteatoma recidivism, postoperative complications, Merchant grade, hearing outcome. Patients underwent CWU or CWD mastoidectomy using S53P4 BAG. Both canal wall up (CWU) and canal wall down (CWD) procedures were included. Study DesignĪll 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. To present the long-term outcomes of mastoid obliteration in cholesteatoma surgery using S53P4 bioactive glass (BAG) in an adult population. ![]()
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