Obliteration von Mastoidhöhlen

Schimanski, G.; Schimanski, E.

doi:10.1007/s00106-015-0028-3

Cited by 11 publications

(2 citation statements)

References 31 publications

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“…Several studies reported on SSI after mastoid obliteration with BAG S53P4 in the management of chronic otitis media with and without cholesteatoma ( Bernardeschi, 2015 ; de Veij Mestdagh, 2017 ; Król, 2021 ; Leonard, 2021 ; Mishra, 2021 ; Sarin, 2012 ; Schimanski, 2015 ; Silvola, 2012 ; Sorour, 2018 ; Stoor, 2010 ; Vos, 2017 ) (see supplementary information, Table S2 ). The SSI rates in these studies vary from 0 to 2% and are lower compared to our rate of 12%, except for Silvola et al.…”

Section: Discussionmentioning

confidence: 99%

“…Schimanski et al. concluded that in the case of obliteration with BAG S53P4 postoperative use of a drain was beneficial to avoid accumulation of seroma fluid in the mastoid and thereby reducing the risk on an SSI ( Schimanski, 2015 ). Also, in other studies where a drain was used postoperatively no SSIs were reported ( Veij Mestdagh, 2017 ; Vos, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

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Postoperative surgical site infection in cholesteatoma surgery with and without mastoid obliteration, what can we learn?

et al. 2022

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Introduction This study aims to describe the occurrence of postoperative complications related to cholesteatoma surgery and to determine factors influencing the most common complication, i.e. postoperative surgical site infection (SSI) in cases with and without mastoid obliteration. Materials and methods Retrospective analyses were performed on surgically treated cholesteatomas in our hospital between 2013 and 2019. Patient characteristics, peri- and postoperative management and complications were reviewed. The cases were divided into two groups based on whether mastoid obliteration was performed or not. Results A total of 336 cholesteatoma operations were performed, of which 248 cases received mastoid obliteration. In total 21 complications were observed, of which SSI was the most common (15/21). No difference in occurrence of any postoperative complication was seen between the obliteration and no-obliteration group ( p = 0.798), especially not in the number of SSI ( p = 0.520). Perioperative and/or postoperative prophylactic antibiotics were not associated to the development of an SSI in both groups. In the no-obliteration group a younger age (p = 0.015), as well as primary surgery ( p = 0.022) increased the risk for SSI. In the obliteration group the use of bioactive glass (BAG) S53P4 was identified as independent predictor of SSI ( p = 0.008, OR 5.940). Discussion SSI is the most common postoperative complication in cholesteatoma surgery. The causes of SSI are multifactorial, therefore further prospective research is needed to answer which factors can prevent the development of an SSI in cholesteatoma surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postoperative surgical site infection in cholesteatoma surgery with and without mastoid obliteration, what can we learn?

et al. 2022

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Management of tegmen defects with mastoid and epitympanic obliteration using S53P4 bioactive glass

Remangeon¹,

Lahlou²,

Alciato³

et al. 2020

Laryngoscope Investig Oto

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Objective: To evaluate the surgical results and complications in a cohort of patients operated on to repair a tegmen bony defect using either transmastoid approach with obliteration using S53P4 bioactive glass granules (TMA-O), or the classic middle cranial fossa approach (MCFA). Study design:A retrospective monocentric study.Methods: Twenty-five cases (24 patients) were included. Data regarding patient demographics, etiology, intraoperative findings, complications, recurrences, audiometric data, and follow-up were analyzed.Results: Seven patients were operated with MCFA and 17 patients with TMA-O.One patient was operated on using a combined approach (MCFA + TMA-O). In the preoperative HRCT scan, the size of the defect was estimated to be 6 ± 3.8 mm in the TMA-O group and 6 ± 3.5 mm in the MCFA group (P = .969). Intraoperatively, in the MCFA group, the location of the defect was mostly anterior (86%) with an intact ossicular chain (86%). A discontinuous chain was observed in 15 patients (88%) in the TMA-O group. The mean follow-up time was 22 ± 14 months in the TMA-O group and 24 ± 15 months in the MCFA group (P = .762). In both groups, there were no early postoperative complications or recurrences during follow-up.Conclusion: Repair of a tegmen bony defect with S53P4 bioactive glass granules seems to be safe and effective, limiting the use of the middle cranial fossa approach to cases with epitympanic defects and with an intact ossicular chain, and it could be used whatever the size of the defect and/or the presence of meningoencephalocele.

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Bioactive glass obliteration of the mastoid significantly improves surgical outcome in non-cholesteatomatous chronic otitis media patients

Vos

Mestdagh

Colnot

et al. 2017

Eur Arch Otorhinolaryngol

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This retrospective follow-up study evaluates the efficacy and safety of bioactive glass (BAG) S53P4 when applied as filler material in mastoid obliteration surgery performed on non-cholesteatomatous chronic otitis media (NC-COM) patients with chronically discharging ears despite conservative therapy. 94 Patients (96 ears) were included. Patients underwent either intact canal wall (ICW) or canal wall down (CWD) mastoid surgery between 2005 and 2015. The intervention group comprised 23 patients (23 ears) who were treated with additional mastoid obliteration using BAG S53P4; the remaining 71 patients (73 ears) were considered controls. All patients underwent preoperative CT scanning of the mastoid. Primary functional outcome, as defined by control of suppuration, was assessed using Merchant's scale. Hearing results as measured by air-bone gap and the incidence of adverse events were assessed as secondary outcomes. Thirty-two ears (44%) in the control group (n = 73) achieved complete control of infection at the most recent postoperative clinic visit vs 17 (74%) in the S53P4 obliteration group (n = 23). Comparing these outcomes yielded an odds ratio (OR) of 3.6 (p = 0.012, 95% CI 1.3-10.3). Complete failure to manage infection significantly differed (p = 0.048) between the control group (11 ears; 15%) and the S53P4 obliteration group (0 ears). No adverse events were observed in either group. Pre- and postoperative ABG results did not differ significantly between groups. Obliteration of the mastoid cavity using BAG S53P4 along with mastoidectomy in patients with chronically discharging NC-COM significantly improves the achievement of a dry and safe ear as compared to mastoidectomy alone. Importantly, no adverse events were observed with S53P4 BAG obliteration.

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Obliteration von Mastoidhöhlen

Abstract: In our experience, a combination of BAG S53P4 and cartilage as cover is a suitable material for cavity obliteration.

Cited by 11 publications

References 31 publications

Postoperative surgical site infection in cholesteatoma surgery with and without mastoid obliteration, what can we learn?

Postoperative surgical site infection in cholesteatoma surgery with and without mastoid obliteration, what can we learn?

Management of tegmen defects with mastoid and epitympanic obliteration using S53P4 bioactive glass

Bioactive glass obliteration of the mastoid significantly improves surgical outcome in non-cholesteatomatous chronic otitis media patients

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