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Glass ionomer cement in otological microsurgery: experience over 16 years
F Righini-Grunder1, R Häusler, S Chongvisal
1University Department of ENT, Head and Neck Surgery, Inselspital, Bern, Switzerland.
Summary
Glass ionomer cement (GIC) shows safety and utility in middle ear surgeries like stapes repair and cochlear implants. While effective for prosthesis fixation and hearing gain, potential complications include inflammatory reactions and cement breakage, necessitating careful application.
Area of Science:
- Otolaryngology
- Biomaterials Science
- Surgical Innovation
Background:
- Glass ionomer cement (GIC) has been utilized in otologic procedures.
- Its application in middle ear surgery requires evaluation for safety and efficacy.
- Long-term outcomes and potential complications need thorough assessment.
Purpose of the Study:
- To retrospectively evaluate the safety and efficacy of GIC in various middle ear surgeries.
- To analyze technical aspects, benefits, and complications associated with GIC use.
- To determine the suitability of GIC for specific otologic applications.
Main Methods:
- Retrospective analysis of 444 patients undergoing middle ear surgery with GIC between 1995 and 2006.
- Follow-up until 2011 (mean 10 years) to assess short- and long-term outcomes.
- Detailed review of GIC application in stapes surgery, cochlear implants, ossiculoplasty, and fistula closure.
Main Results:
- GIC demonstrated utility in stapes surgery for prosthesis fixation, potentially reducing incus necrosis.
- In cochlear implants, GIC was used for casing and electrode fixation with a 4.3% inflammatory reaction rate.
- GIC showed success in incudo-stapedial gap repair and fistula closure, though cement breakage occurred in 43% of gap repairs.
Conclusions:
- Targeted use of GIC in middle ear surgery is generally safe and effective.
- GIC is particularly beneficial for prosthesis fixation in stapes surgery.
- Contraindicated in neuro-otosurgery due to potential complications with cerebrospinal fluid.
