Juha Tapio Silvola1. 1. ENT Department, Päijät-Häme Central Hospital, Lahti, Finland. juha.silvola@phks.fi
Abstract
OBJECTIVE: To show that mastoid cavities with continuous infections and cleaning problems can be obliterated with bioactive glass (BG) and to present results of a pilot study for 16 operations on adults. STUDY DESIGN: Case series with planned data collection. SETTING: Päijät-Häme Central Hospital, Finland-a single ear, nose, and throat (ENT) hospital department serving a population of 216,000. SUBJECTS AND METHODS: Fourteen patients had a large open radical cavity with recurrent infections. Two ears had discharge and pain after simple mastoidectomy. A re-mastoidectomy included support of the cavity skin and obliteration with BG. The mean follow-up time was 2.2 years. RESULTS: All ears became dry. One reoperation was needed as the fascia support to the ear canal (EC) skin was too weak, and part of the BG leaked into the EC. The ear stayed dry, and the missing BG was replaced in a reoperation. A slightly short musculoperiosteal flap supported the EC skin in 1 ear. A minor amount of BG leaked into the EC. The ear stayed dry. The aim was an ample ear canal. One ear was overfilled and required meatoplasty. Simple mastoid cavities were isolated from the middle ear and become asymptomatic. CONCLUSIONS: In this pilot study, BG works safely and with success as an obliteration material in problematic open radical cavities. Bioactive glass seems to tolerate chronic infection in the mastoid and prevent postoperative infections.
OBJECTIVE: To show that mastoid cavities with continuous infections and cleaning problems can be obliterated with bioactive glass (BG) and to present results of a pilot study for 16 operations on adults. STUDY DESIGN: Case series with planned data collection. SETTING: Päijät-Häme Central Hospital, Finland-a single ear, nose, and throat (ENT) hospital department serving a population of 216,000. SUBJECTS AND METHODS: Fourteen patients had a large open radical cavity with recurrent infections. Two ears had discharge and pain after simple mastoidectomy. A re-mastoidectomy included support of the cavity skin and obliteration with BG. The mean follow-up time was 2.2 years. RESULTS: All ears became dry. One reoperation was needed as the fascia support to the ear canal (EC) skin was too weak, and part of the BG leaked into the EC. The ear stayed dry, and the missing BG was replaced in a reoperation. A slightly short musculoperiosteal flap supported the EC skin in 1 ear. A minor amount of BG leaked into the EC. The ear stayed dry. The aim was an ample ear canal. One ear was overfilled and required meatoplasty. Simple mastoid cavities were isolated from the middle ear and become asymptomatic. CONCLUSIONS: In this pilot study, BG works safely and with success as an obliteration material in problematic open radical cavities. Bioactive glass seems to tolerate chronic infection in the mastoid and prevent postoperative infections.
Authors: Toby W A Gould; John P Birchall; Ali S Mallick; Tamara Alliston; Lawrence R Lustig; Kevin M Shakesheff; Cheryl V Rahman Journal: Laryngoscope Date: 2013-05-13 Impact factor: 3.325