Mastoid obliteration using bioactive glass: Our experience

Hameed, N.; Velusamy, A.; Anand, A.

Introduction: We aim to evaluate the surgical outcome of cavity obliteration with bioactive glass in patients with cholesteatoma undergoing canal wall-down mastoidectomy with reconstruction of canal wall;recognize the presence of postoperative complications such as wound infection, posterior canal wall bulge, and residual perforation;and evaluate the safety of bioglass. This is a prospective study carried out over 3 years;due to COVID-19, we could not enroll enough patients and follow them up for an adequate period of time. Methods: A prospective study was conducted over a period of 3 years on 25 patients who underwent mastoid obliteration with bioactive glass following canal wall-down mastoidectomy for cholesteatoma. The primary outcome measure was the presence of a dry, low-maintainance mastoid cavity that was free of infection, assessed and graded according to the grading system by Merchant et al at the end of 1 month and 6 months, postoperatively. Secondary outcome measures included presence of postoperative complications sucha s wound infection, posterior canal wall bulge, and residual perforation. Results: Of the 25 patients included in this study, at the end of 1 month, 60% had a completely dry ear and 28% had grade 1 and 12% had grade 2 otorrhea. At the end of 6 months, 72% had a completely dry ear, while 20% had grade 1 and 8% had grade 2 otorrhoea. There were no cases with grade 3 otorrhoea during the entire follow-up period. Postoperative complication of a posterior canal bulge was noted in 2 patients (8%), and only 1 patient (4%) had a residual perforation. Conclusion: Mastoid cavity obliteration with bioactive glass is an effective technique to avoid cavity problems.