Mastoidectomy cavity obliteration with bioactive glass: a pilot study

Area of Science:

• Otolaryngology
• Biomaterials Science
• Surgical Innovation

Background:

• Chronic infections and cleaning difficulties in open mastoid cavities pose significant challenges.
• Existing treatments for such conditions can be invasive and may not always yield satisfactory long-term results.
• Mastoid obliteration aims to eliminate dead space, prevent recurrent infections, and improve patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of using bioactive glass (BG) for obliterating problematic mastoid cavities.
• To present the outcomes of a pilot study involving 16 adult patients undergoing mastoid obliteration with BG.
• To assess BG's potential to manage chronic infections in mastoid cavities.

Main Methods:

• A case series design with planned data collection was employed.
• Sixteen adult patients with problematic mastoid cavities (recurrent infections, post-mastoidectomy discharge/pain) underwent re-mastoidectomy with BG obliteration.
• The mean follow-up period was 2.2 years, with detailed monitoring of surgical outcomes and complications.

Main Results:

• All treated ears achieved a dry status post-procedure.
• One reoperation was necessary due to insufficient fascial support causing minor BG leakage into the ear canal; the ear remained dry.
• Minor BG leakage occurred in another case, but the ear remained dry; one case required meatoplasty due to overfilling.

Conclusions:

• Bioactive glass (BG) is a safe and effective material for obliterating open radical mastoid cavities with chronic infection issues.
• BG demonstrates tolerance to chronic mastoid infections and appears to prevent postoperative infections, leading to asymptomatic cavities.
• This pilot study supports BG as a viable option for managing complex mastoid cavity problems.