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Mastoid obliteration with hydroxyapatite cement: the Ipswich experience
1ENT Department, Ipswich Hospital NHS Trust, England.
Summary
Hydroxyapatite cement is not recommended for mastoid obliteration due to high infection rates. Hydroxyapatite granules offer a superior alternative, resulting in dry, well-healed mastoid cavities and good swimming tolerance post-surgery.
Area of Science:
- Otology and reconstructive surgery
- Biomaterials in surgical applications
Background:
- Mastoid obliteration aims to create a dry, safe ear by filling the mastoid cavity.
- Hydroxyapatite-based materials are used for mastoid obliteration, but their efficacy varies.
Purpose of the Study:
- To compare the outcomes of mastoid obliteration using hydroxyapatite cement versus hydroxyapatite granules.
Main Methods:
- Nonrandomized observational analysis conducted at a tertiary otology unit.
- Inclusion of patients undergoing primary or revision mastoid surgery with obliteration.
- Evaluation of mastoid cavity status (dryness, epithelialization) and swimming tolerance at 1 year postoperatively.
Main Results:
- Four out of eight patients (50%) who received hydroxyapatite cement obliteration experienced infection, necessitating revision surgery.
- All patients who underwent obliteration with hydroxyapatite granules achieved dry, well-epithelialized mastoid cavities.
- Hydroxyapatite granule group demonstrated good tolerance to swimming at the 1-year follow-up.
Conclusions:
- Hydroxyapatite cement is associated with a high rate of infectious complications and is not recommended for mastoid obliteration.
- Hydroxyapatite granules provide a safe and effective alternative for mastoid obliteration, leading to favorable long-term outcomes.
