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Acta Otolaryngol. 2017 Jul;137(7):690-694. doi: 10.1080/00016489.2017.1279346. Epub 2017 Jan 26.

Mastoid obliteration with S53P4 bioactive glass in cholesteatoma surgery.

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a Department of Otolaryngology and Head and Neck Surgery , Diakonessenhuis Utrecht , Utrecht , The Netherlands.
b Research Support , Diakademie, Diakonessenhuis Utrecht , Utrecht , The Netherlands.



Evaluation of the follow-up of 67 patients shows that S53P4 bioactive glass (BAG) granules are safe and effective as obliteration material in cholesteatoma surgery.


To investigate the safety and efficacy of mastoid obliteration using S53P4 BAG in cholesteatoma surgery. Clinical outcomes were infection control (Merchant's grading), cholesteatoma recidivism, and audiometric performance.


Retrospective follow-up study at the Diakonessenhuis, Utrecht, the Netherlands. Eighteen young (age <17 years) and 49 adult (age ≥17 years) patients treated for cholesteatoma underwent tympanomastoidectomy with mastoid obliteration using S53P4 BAG in the period 2012-2015. Outcome was monitored with clinical otoscopy, otorrhea incidence measurement (Merchant's grading), DW-MRI, and audiographic performance analyses (pure tone average and air bone gap).


During the follow-up period (mean = 22 months; range = 12-54 months) cholesteatoma recidivism was observed in 6% of the patients (four ears), mostly in young patients (three ears). An acceptably dry ear (Merchant grade 0-1) was achieved in 96% of all cases. The remaining 4% of cases scored a Merchant grade 2. Overall, both air conduction thresholds and air bone gap were slightly lowered when comparing post-operative values to pre-operative values and significantly in the case of ossicular reconstruction. In none of the patients (0%) did post-operative wound infections occur.


S53P4; bioactive glass; cholesteatoma; mastoid obliteration

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