Bioactive glass (S53P4) as obliteration material in subtotal petrosectomy: initial experience

Chronic suppurative otitis media often requires subtotal petrosectomy. This procedure leaves a mastoid cavity that needs filling. Traditionally, abdominal fat is used for this purpose. However, this method carries infection risks. Prior research has shown that fat grafts can lead to complications requiring revision. No prior work had resolved the issue of infection-free alternatives. This gap motivated exploration of bioactive materials. S53P4 bioactive glass has antibacterial properties. It was already known that bioactive glass can integrate with bone and tissue.

The aim of this clinical report was to evaluate S53P4 bioactive glass as an alternative to fat for cavity obliteration. Chronic otorrhoea and pain persisted in patients despite conservative treatment. Subtotal petrosectomy was performed to eliminate the source of infection. The study sought to assess the feasibility and safety of this approach. The researchers proposed that bioactive glass could reduce infection risks. They also aimed to determine if a dry ear could be achieved. No prior studies had tested this material in this specific surgical context. This work addresses a specific clinical need in otologic surgery.

The study involved two patients with chronic suppurative otitis media. Both had undergone prior surgical and conservative treatments. Subtotal petrosectomy was performed to remove infected tissue. The cavities were then filled with S53P4 bioactive glass granules. No fat grafts were used in either case. Peri-operative monitoring tracked for complications. Follow-up periods lasted 18 and 84 months. Outcomes were assessed for dry ear status and adverse events.

No peri-operative complications occurred in either patient. Both achieved a dry ear status following the procedure. No late adverse events were observed during follow-up. The 84-month follow-up showed sustained success. The 18-month follow-up also demonstrated no complications. S53P4 bioactive glass remained stable in the cavities. The material showed no signs of degradation or infection. These findings suggest the material is suitable for this application.

The authors concluded that S53P4 bioactive glass is feasible for cavity obliteration. They noted that this material may reduce infection risks compared to fat. The technique achieved elimination of chronic suppurative otitis media. The dry ear status was maintained in both cases. No late complications were observed in either patient. The researchers propose that this approach could be an attractive alternative. They suggest that further studies may confirm these findings. The authors emphasize the potential clinical relevance of this method.