Mastoid cavity obliteraion and implantation of bonebridge in revision cholesteatoma surgery

Patients with advanced chronic otitis media with cholesteatoma require surgery with canal wall-down technique. After removal of the cholesteatoma matrix, the operatively created radical mastoid cavity is desirable to be eliminated by obliteration. This study present the first results from simultaneously using of bone pate or S53P4 bioactive glass and active bone conduction implant for mastoid cavity obliteration in revision cholesteatoma surgery. We present 3 patients (Patient 1: M.T., 45 years, female; Patient 2: G.G., 6 years, femal; Patient 2: N.C., 50, female) with history of bilateral chronic otitis media with cholesteatoma after multiple prior radical surgery treatments comprehensively by obliteration and active bone conduction implant in the mastoid area. Retrospective case report study. The patients are actively monitored for many years (Patient 1 from 2015; Patient 2 from 2019; Patient 3 from 2022) for the state of hearing and the presence of cholesteatoma recurrence. Hearing studies show very good auditory rehabilitation of hearing loss as well computer tomography scan of the temporal bone showed that the active bone conduction implant is in a good position in the mastoid cavity with good bone contact on a wide base. After this radical surgery and during the follow-up period, we did not notice any serious postoperative complications. This multi-stage surgical procedure is indicated in these clinical cases with bilateral chronic otitis media with cholesteatoma and previous multiple surgical interventions involving the auditory chain, leading to significant changes in normal anatomical conditions. It is necessary to follow a larger group of patients with similar clinical and anatomical features in order to reach valid conclusions.

Publication History

Article published online:
12 May 2023