[Diminution of radical surgical cavities with hydroxyapatite]

Canal wall surgery is the safest way to eradicate cholesteatoma and to prevent recurrence of the disease. On the other hand, resulting cavity problems such as a permanently discharging ear and poor functional results made the development of alternative procedures necessary. A new technique to obliterate the mastoid volume or to reduce an old cavity by means of hydroxyapatite granulate is presented. Characteristics of the material and how to manage it are demonstrated. First experiences in 30 ears are reported. Hydroxyapatite granulate enables us to establish a primarily epithelized small cavity. Since hydroxyapatite is the anorganic component of bone its biocompatibility is excellent. It is hardly resorbed, osteointegrated and induces a new formation of bone. The size of the open cavity can therefore be designed exactly during the operation and sliding and vanishing of mass as seen in soft tissue flaps (muscle and connective tissue only) can be avoided.