Related Experiment Video
Updated: Jan 13, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Does Mastoid and Epitympanic Obliteration With S53P4 Bioactive Glass Reduce Cholesteatoma Recidivism in Canal-Wall-Up
Hugo Delille1, Daniele Bernardeschi1, Matteo Di Bari1
1Otology, auditory implants and skull base surgery department, Pitié-Salpêtrière Hospital, AP-HP.
Objective:
The aim of this study was to compare canal-wall-up tympano-mastoidectomy with or without mastoid and epitympanic obliteration, and to estimate the 5-year recidivism rate using Kaplan-Meier survival analysis.
Study Design:
Retrospective cohort study.
Patients:
One hundred seventy-two consecutive ears with a diagnosis of cholesteatoma who underwent canal-wall-up tympano-mastoidectomy with or without obliteration with S53P4 bioactive glass granules (S53P4 and NO group) from January 2008 to December 2019.
Intervention:
BAG obliteration.
Setting:
Single-center study in a tertiary referral center.
Main Outcome Measure:
Cholesteatoma recidivism, recurrent and residual disease.
Results:
In our population, cholesteatoma recidivism rate was 18% in the NO group and 5% in the S53P4 group (P < 0.01). The overall cholesteatoma-free survival rate at 5 years, calculated with the log-rank test for survival analysis, was 87.8% (95% CI, 77.8-99) in the S53P4 group and 58.2% (95% CI, 42.6-79.5) in the NO group (P < 0.01). The recurrent cholesteatoma-free survival rate at 5 years was 89% (95% CI, 79.1-100) in the S53P4 group and 65.8% (95% CI, 49.4-87.6) in the NO group. Recurrent disease significantly differed between the two groups (P = 0.018).
Conclusion:
Mastoid and epitympanic obliteration using S53P4 bioactive glass significantly reduced the recurrence of cholesteatoma in patients undergoing canal-wall-up tympano-mastoidectomy. These findings suggest a potential benefit of obliteration when mastoidectomy is required.
