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Updated: Mar 8, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Mastoid obliteration with S53P4 bioactive glass in cholesteatoma surgery
Pieter D de Veij Mestdagh1, David R Colnot1, Pepijn A Borggreven1
1a Department of Otolaryngology and Head and Neck Surgery , Diakonessenhuis Utrecht , Utrecht , The Netherlands.
Conclusion:
Evaluation of the follow-up of 67 patients shows that S53P4 bioactive glass (BAG) granules are safe and effective as obliteration material in cholesteatoma surgery.
Objectives:
To investigate the safety and efficacy of mastoid obliteration using S53P4 BAG in cholesteatoma surgery. Clinical outcomes were infection control (Merchant's grading), cholesteatoma recidivism, and audiometric performance.
Methods:
Retrospective follow-up study at the Diakonessenhuis, Utrecht, the Netherlands. Eighteen young (age <17 years) and 49 adult (age ≥17 years) patients treated for cholesteatoma underwent tympanomastoidectomy with mastoid obliteration using S53P4 BAG in the period 2012-2015. Outcome was monitored with clinical otoscopy, otorrhea incidence measurement (Merchant's grading), DW-MRI, and audiographic performance analyses (pure tone average and air bone gap).
Results:
During the follow-up period (mean = 22 months; range = 12-54 months) cholesteatoma recidivism was observed in 6% of the patients (four ears), mostly in young patients (three ears). An acceptably dry ear (Merchant grade 0-1) was achieved in 96% of all cases. The remaining 4% of cases scored a Merchant grade 2. Overall, both air conduction thresholds and air bone gap were slightly lowered when comparing post-operative values to pre-operative values and significantly in the case of ossicular reconstruction. In none of the patients (0%) did post-operative wound infections occur.
