Daniele Bernardeschi1,2, Bruno Law-Ye3, Franck Bielle4, Baptiste Hochet1,2, Olivier Sterkers1,2, Didier Dormont3, Nadya Pyatigorskaya5,6,7. 1. AP-HP, Otology, Auditory Implants and Skull Base Surgery Department, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, 75013, Paris, France. 2. Inserm UMR_S 1159, "Réhabilitation chirurgicale mini-invasive et robotisée de l'audition", F-75018, Paris, France. 3. AP-HP, Neuroradiology department, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, 75013, Paris, France. 4. AP-HP, Neuropathology Department, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, 75013, Paris, France. 5. AP-HP, Neuroradiology department, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, 75013, Paris, France. nadya.pyatigorskaya@aphp.fr. 6. UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Sorbonne Universités, F-75013, Paris, France. nadya.pyatigorskaya@aphp.fr. 7. Neuroradiology Department, Pitié-Salpetriere Hospital, 75013, Paris, France. nadya.pyatigorskaya@aphp.fr.
Abstract
PURPOSE: To evaluate the appearance of mastoid and epitympanic obliteration using S53P4 bioactive glass (BG) granules in high-resolution computed tomography (HRCT) and MRI. MATERIALS AND METHODS: Patients undergoing mastoid and epitympanic obliteration between May 2013 and December 2015 were prospectively included in an uncontrolled clinical study. All patients underwent a temporal HRCT scan 1 year after surgery, aimed at evaluating the attenuation, homogeneity, and osseointegration of the BG granules, as well as the ventilation of the middle ear and the volume of the obliterated paratympanic spaces. If a cholesteatoma was found during surgery, additional MRI, including at least pre- and post-contrast T1-weighted, T2-weighted, and axial non-echo-planar diffusion-weighted (DW) sequences, was performed 1 year after surgery, to study the normal signal of the BG granules and the presence of residual cholesteatoma and/or other temporal bone pathologies. RESULTS: Seventy cases were included. On 1-year HRCT, the mean attenuation of the BG granules was 888.34 ± 166.10 HU. The obliteration was found to be mostly homogeneous with partial osseointegration. The appearance of the BG granules having a low-intensity signal in T2-weighted imaging and DW MRI was always different from the appearance of cholesteatoma. A longer follow-up has shown no attenuation or signal modification of the BG granules compared with the 1-year imaging. CONCLUSION: Radiological follow-up of patients operated on with mastoid and epitympanic obliteration using BG granules is effective using both HRCT and MRI. A cholesteatoma and/or other potential complications could easily be detected due to the specific radiological appearance of the BG granules. KEY POINTS: • The appearance of mastoid and epitympanic obliteration by S53P4 bioactive glass (BG) granules on high-resolution computed tomography (HRCT) scans was homogeneous with an attenuation significantly higher than the attenuation of cholesteatoma and lower than mastoid bone attenuation. • The granules have a low-intensity signal on non-echo-planar diffusion-weighted sequences and on T2-weighted images and present contrast enhancement allowing the differential diagnosis with cholesteatoma and effective for the detection of other underlying temporal bone pathologies. • The volume and radiological appearance of the obliteration appear to be stable with time.
PURPOSE: To evaluate the appearance of mastoid and epitympanic obliteration using S53P4 bioactive glass (BG) granules in high-resolution computed tomography (HRCT) and MRI. MATERIALS AND METHODS:Patients undergoing mastoid and epitympanic obliteration between May 2013 and December 2015 were prospectively included in an uncontrolled clinical study. All patients underwent a temporal HRCT scan 1 year after surgery, aimed at evaluating the attenuation, homogeneity, and osseointegration of the BG granules, as well as the ventilation of the middle ear and the volume of the obliterated paratympanic spaces. If a cholesteatoma was found during surgery, additional MRI, including at least pre- and post-contrast T1-weighted, T2-weighted, and axial non-echo-planar diffusion-weighted (DW) sequences, was performed 1 year after surgery, to study the normal signal of the BG granules and the presence of residual cholesteatoma and/or other temporal bone pathologies. RESULTS: Seventy cases were included. On 1-year HRCT, the mean attenuation of the BG granules was 888.34 ± 166.10 HU. The obliteration was found to be mostly homogeneous with partial osseointegration. The appearance of the BG granules having a low-intensity signal in T2-weighted imaging and DW MRI was always different from the appearance of cholesteatoma. A longer follow-up has shown no attenuation or signal modification of the BG granules compared with the 1-year imaging. CONCLUSION: Radiological follow-up of patients operated on with mastoid and epitympanic obliteration using BG granules is effective using both HRCT and MRI. A cholesteatoma and/or other potential complications could easily be detected due to the specific radiological appearance of the BG granules. KEY POINTS: • The appearance of mastoid and epitympanic obliteration by S53P4 bioactive glass (BG) granules on high-resolution computed tomography (HRCT) scans was homogeneous with an attenuation significantly higher than the attenuation of cholesteatoma and lower than mastoid bone attenuation. • The granules have a low-intensity signal on non-echo-planar diffusion-weighted sequences and on T2-weighted images and present contrast enhancement allowing the differential diagnosis with cholesteatoma and effective for the detection of other underlying temporal bone pathologies. • The volume and radiological appearance of the obliteration appear to be stable with time.
Authors: J Rantakokko; J P Frantzén; J Heinänen; S Kajander; E Kotilainen; E Gullichsen; N C Lindfors Journal: Scand J Surg Date: 2012 Impact factor: 2.360
Authors: Nina C Lindfors; Ilona Koski; Jouni T Heikkilä; Kimmo Mattila; Allan J Aho Journal: J Biomed Mater Res B Appl Biomater Date: 2010-07 Impact factor: 3.368
Authors: Victor J Kroon; Steven W Mes; Pepijn A Borggreven; Rick van de Langenberg; David R Colnot; Jasper J Quak Journal: Eur Arch Otorhinolaryngol Date: 2022-10-08 Impact factor: 3.236