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.

Autor:	Kroon VJ, Mes SW; Department of Otolaryngology and Head and Neck Surgery, Diakonessenhuis Utrecht., Borggreven PA; Department of Otolaryngology and Head and Neck Surgery, Diakonessenhuis Utrecht., van de Langenberg R; Department of Otolaryngology and Head and Neck Surgery, Diakonessenhuis Utrecht., Colnot DR; Department of Otolaryngology and Head and Neck Surgery, Diakonessenhuis Utrecht., Quak JJ; Department of Otolaryngology and Head and Neck Surgery, Diakonessenhuis Utrecht.
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2022 Dec 01; Vol. 43 (10), pp. 1181-1188. Date of Electronic Publication: 2022 Sep 13.
DOI:	10.1097/MAO.0000000000003685
Abstrakt:	Objective: To present the long-term outcomes of mastoid obliteration in cholesteatoma surgery using S53P4 bioactive glass (BAG) in an adult population. Study Design: 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 and Measures: 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. Competing Interests: The authors disclose no conflicts of interest. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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