Reconstruction of old radical cavities

Area of Science:

• Otolaryngology
• Biomaterials Science
• Regenerative Medicine

Background:

• Radical cavities can lead to persistent infections and social limitations.
• Existing treatments for radical cavities have limitations, including recurrence and inconvenience.
• Reconstruction of radical cavities is essential for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of revalidating old radical cavities using a mixture of tricalcium phosphate and hydroxyapatite granules.
• To assess the anatomical and functional results of different posterior canal wall reconstruction techniques.
• To determine the long-term hearing gain and graft success rates.

Main Methods:

• Twenty-four patients with chronic discharging old radical cavities underwent surgery.
• A mixture of tricalcium phosphate and hydroxyapatite granules was used as filling material.
• Three techniques for posterior canal wall reconstruction were employed: fibrin adhesive, bone pate-fibrin sealant, and septal cartilage homografts.

Main Results:

• Anatomical success rate of 91.7% for graft uptake was achieved.
• Functional results showed an air-bone gap less than 30 dB in 72.7% of cases at 6 months.
• Satisfactory hearing gain was observed in 63.6% of patients after 2 years.
• No significant difference in outcomes was noted between the different reconstruction methods.

Conclusions:

• Revalidation of old radical cavities with tricalcium phosphate and hydroxyapatite granules is an effective treatment.
• The applied reconstruction techniques for the posterior canal wall do not impact the overall success.
• This approach offers a viable solution for managing chronic radical cavities, improving both anatomical and functional results.