Abstract

Introduction: Surgical management of cholesteatoma consists of mainly canal wall up (CWU) or canal wall down (CWD) mastoidectomy. CWD mastoidectomy is associated with lower rate of recidivism but requiring long-term care. The associated mastoid cavity from CWD surgery can be obliterated to reduce cavity size and subsequent long-term care. We aimed to assess suitability of beta-tricalcium phosphate in a hydroxyl sulphate matrix (CPHSM), a biopolymer, in mastoid obliteration.

Methods: Research ethics approval was obtained. A prospective observational study of six patients that required revision mastoidectomy was undertaken with a follow-up period of a year. Study outcome measures included ear canal volume, pure-tone audiometry and documentation of any post-operative infections in the operated ear.

Results: A total of six patients were included in the study with one patient eventually excluded as recurrent cholesteatoma was identified intra-operatively. Three (60%) patients had extrusion or resorption of the polymer at 1 year’s follow-up. The polymer integrated into the mastoid cavity in one (20%) patient who did not have any further infections. The remaining patient did not attend long-term follow-up. There was no change in pre and post-operative hearing thresholds.

Conclusion: CPHSM in its current form is not suitable for routine use. There is no evidence of ototoxicity and CPHSM was easy to use but there was a high rate of early infection, extrusion and resorption.

Keywords: Canal Wall Up (CWU); Cavity; Beta-tricalcium Phosphate

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Citation

Citation: Tawakir Kamani., et al. “A Proof of Concept: Does Beta-tricalcium Phosphate in a Hydroxyl Sulphate Matrix Reduce Cavity Size and Problems in Revision Mastoidectomy Patients". Acta Scientific Otolaryngology 2.9 (2020): 14-18.

Copyright

Copyright: © 2020 Tawakir Kamani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.