Mastoid obliteration with hydroxyapatite vs. bone pâté in mastoidectomy surgery performed on patients with cholesteatoma and chronic suppurative otitis media: a retrospective analysis
Purpose To compare the efficacy and safety of hydroxyapatite vs. bone pâté as obliteration material in mastoidectomy surgery for patients with chronic suppurative otitis media and cholesteatoma. Methods This is a retrospective, multi-center, cohort study. All patients were followed up with micro-oto...
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| Veröffentlicht in: | European archives of oto-rhino-laryngology 2023-04, Vol.280 (4), p.1703-1711 |
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| creator | Lindeboom, Jantine J. van Kempen, P. M. W. Buwalda, J. Westerlaken, B. O. van Zuijlen, D. A. Bom, S. J. H. van der Beek, F. B. |
| description | Purpose
To compare the efficacy and safety of hydroxyapatite vs. bone pâté as obliteration material in mastoidectomy surgery for patients with chronic suppurative otitis media and cholesteatoma.
Methods
This is a retrospective, multi-center, cohort study. All patients were followed up with micro-otoscopy, audiometry, and, if indicated, MRI with diffusion-weighted imaging. The following outcome parameters were analyzed: procedure safety (wound infections and complications), cholesteatoma recidivism rates (residual/recurrent), control of infection (Merchant’s scale), and hearing results (pure-tone averages at 500/1000/2000/4000 Hz).
Results
Eighty-three cases were included: 45 obliterated with hydroxyapatite and 38 with bone pâté, with a mean follow-up time of, respectively, 25 and 24 months. Wound infections were only detected in the bone pâté group (4.8%) and successfully treated with oral or intravenous antibiotics and surgical drainage (
p
= 0.026). No other major surgical complications were observed in both groups. Cholesteatoma recidivism was observed in 15% using hydroxyapatite and 12% using bone pâté (
p
= 0.471). Complete control of infection (Merchant 0) was achieved in 76.2% using bone pâté and 86.8% using hydroxyapatite at 12 months postoperatively (
p
= 0.223). All patients showed good postoperative healing without complete failure to manage infection (Merchant 3). Pre- and postoperative audiometry showed significant improvement in hearing results in both groups. No significant difference between the obliteration materials was observed.
Conclusions
Evaluation of mastoid obliteration reveals that hydroxyapatite and bone pâté are safe and effective obliteration materials, with high success rates in achieving a dry ear, low recidivism rates, and good hearing outcome, respecting the short-term limitation. In addition, our study shows that hydroxyapatite results in fewer postoperative wound infections compared to bone pâté. |
| doi_str_mv | 10.1007/s00405-022-07661-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2719419925</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2719419925</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-acf4d88c82556c77d46095ee71247ed7b3938c97ad37455bf530bd2d4207e8913</originalsourceid><addsrcrecordid>eNp9kb2O1TAQhS0EYi8LL0CBXNJk8W-c0KEVf9IiGqgtx55wvUrsYDsLeR06HoF6XwxfslBSWZo555vxHISeUnJBCVEvMiGCyIYw1hDVtrTp7qEDFVw0QrH2PjqQnqtGCKXO0KOcrwkhUvT8ITrjLVVcCH5Avz6YXKJ3OA6TL5BM8THgb74c8XFzKX7fzFJrBfBNvsBDDICX2x_l9if2Ac-7F2yJ84bzmr5A2vACaYxphsoM-GSGUPKOtMc4QS5gqsFgE1ytpBi8reZlWU_TbwDHOs9nXAnevMQGJygp5qWOOXVNMNOWfX6MHoxmyvDk7j1Hn9-8_nT5rrn6-Pb95aurxnKhSmPsKFzX2Y5J2VqlnGhJLwEUZUKBUwPveWd7ZRxXQsphlJwMjjnBiIKup_wcPd-5S4pf17q9nn22ME0mQFyzZor2gvY9k1XKdqmt--YEo16Sn03aNCX6FJneI9M1Mv0nMt1V07M7_jrUL_-z_M2oCvguyLUV6on1dVxTvUL-H_Y3jDKo4w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2719419925</pqid></control><display><type>article</type><title>Mastoid obliteration with hydroxyapatite vs. bone pâté in mastoidectomy surgery performed on patients with cholesteatoma and chronic suppurative otitis media: a retrospective analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Lindeboom, Jantine J. ; van Kempen, P. M. W. ; Buwalda, J. ; Westerlaken, B. O. ; van Zuijlen, D. A. ; Bom, S. J. H. ; van der Beek, F. B.</creator><creatorcontrib>Lindeboom, Jantine J. ; van Kempen, P. M. W. ; Buwalda, J. ; Westerlaken, B. O. ; van Zuijlen, D. A. ; Bom, S. J. H. ; van der Beek, F. B.</creatorcontrib><description>Purpose
To compare the efficacy and safety of hydroxyapatite vs. bone pâté as obliteration material in mastoidectomy surgery for patients with chronic suppurative otitis media and cholesteatoma.
Methods
This is a retrospective, multi-center, cohort study. All patients were followed up with micro-otoscopy, audiometry, and, if indicated, MRI with diffusion-weighted imaging. The following outcome parameters were analyzed: procedure safety (wound infections and complications), cholesteatoma recidivism rates (residual/recurrent), control of infection (Merchant’s scale), and hearing results (pure-tone averages at 500/1000/2000/4000 Hz).
Results
Eighty-three cases were included: 45 obliterated with hydroxyapatite and 38 with bone pâté, with a mean follow-up time of, respectively, 25 and 24 months. Wound infections were only detected in the bone pâté group (4.8%) and successfully treated with oral or intravenous antibiotics and surgical drainage (
p
= 0.026). No other major surgical complications were observed in both groups. Cholesteatoma recidivism was observed in 15% using hydroxyapatite and 12% using bone pâté (
p
= 0.471). Complete control of infection (Merchant 0) was achieved in 76.2% using bone pâté and 86.8% using hydroxyapatite at 12 months postoperatively (
p
= 0.223). All patients showed good postoperative healing without complete failure to manage infection (Merchant 3). Pre- and postoperative audiometry showed significant improvement in hearing results in both groups. No significant difference between the obliteration materials was observed.
Conclusions
Evaluation of mastoid obliteration reveals that hydroxyapatite and bone pâté are safe and effective obliteration materials, with high success rates in achieving a dry ear, low recidivism rates, and good hearing outcome, respecting the short-term limitation. In addition, our study shows that hydroxyapatite results in fewer postoperative wound infections compared to bone pâté.</description><identifier>ISSN: 0937-4477</identifier><identifier>EISSN: 1434-4726</identifier><identifier>DOI: 10.1007/s00405-022-07661-8</identifier><identifier>PMID: 36173443</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cholesteatoma, Middle Ear - complications ; Cholesteatoma, Middle Ear - surgery ; Cohort Studies ; Durapatite ; Head and Neck Surgery ; Humans ; Mastoid - surgery ; Mastoidectomy - methods ; Medicine ; Medicine & Public Health ; Neurosurgery ; Otitis Media, Suppurative - complications ; Otitis Media, Suppurative - surgery ; Otology ; Otorhinolaryngology ; Retrospective Studies ; Treatment Outcome</subject><ispartof>European archives of oto-rhino-laryngology, 2023-04, Vol.280 (4), p.1703-1711</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-acf4d88c82556c77d46095ee71247ed7b3938c97ad37455bf530bd2d4207e8913</citedby><cites>FETCH-LOGICAL-c347t-acf4d88c82556c77d46095ee71247ed7b3938c97ad37455bf530bd2d4207e8913</cites><orcidid>0000-0003-2201-4713</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00405-022-07661-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00405-022-07661-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36173443$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lindeboom, Jantine J.</creatorcontrib><creatorcontrib>van Kempen, P. M. W.</creatorcontrib><creatorcontrib>Buwalda, J.</creatorcontrib><creatorcontrib>Westerlaken, B. O.</creatorcontrib><creatorcontrib>van Zuijlen, D. A.</creatorcontrib><creatorcontrib>Bom, S. J. H.</creatorcontrib><creatorcontrib>van der Beek, F. B.</creatorcontrib><title>Mastoid obliteration with hydroxyapatite vs. bone pâté in mastoidectomy surgery performed on patients with cholesteatoma and chronic suppurative otitis media: a retrospective analysis</title><title>European archives of oto-rhino-laryngology</title><addtitle>Eur Arch Otorhinolaryngol</addtitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><description>Purpose
To compare the efficacy and safety of hydroxyapatite vs. bone pâté as obliteration material in mastoidectomy surgery for patients with chronic suppurative otitis media and cholesteatoma.
Methods
This is a retrospective, multi-center, cohort study. All patients were followed up with micro-otoscopy, audiometry, and, if indicated, MRI with diffusion-weighted imaging. The following outcome parameters were analyzed: procedure safety (wound infections and complications), cholesteatoma recidivism rates (residual/recurrent), control of infection (Merchant’s scale), and hearing results (pure-tone averages at 500/1000/2000/4000 Hz).
Results
Eighty-three cases were included: 45 obliterated with hydroxyapatite and 38 with bone pâté, with a mean follow-up time of, respectively, 25 and 24 months. Wound infections were only detected in the bone pâté group (4.8%) and successfully treated with oral or intravenous antibiotics and surgical drainage (
p
= 0.026). No other major surgical complications were observed in both groups. Cholesteatoma recidivism was observed in 15% using hydroxyapatite and 12% using bone pâté (
p
= 0.471). Complete control of infection (Merchant 0) was achieved in 76.2% using bone pâté and 86.8% using hydroxyapatite at 12 months postoperatively (
p
= 0.223). All patients showed good postoperative healing without complete failure to manage infection (Merchant 3). Pre- and postoperative audiometry showed significant improvement in hearing results in both groups. No significant difference between the obliteration materials was observed.
Conclusions
Evaluation of mastoid obliteration reveals that hydroxyapatite and bone pâté are safe and effective obliteration materials, with high success rates in achieving a dry ear, low recidivism rates, and good hearing outcome, respecting the short-term limitation. In addition, our study shows that hydroxyapatite results in fewer postoperative wound infections compared to bone pâté.</description><subject>Cholesteatoma, Middle Ear - complications</subject><subject>Cholesteatoma, Middle Ear - surgery</subject><subject>Cohort Studies</subject><subject>Durapatite</subject><subject>Head and Neck Surgery</subject><subject>Humans</subject><subject>Mastoid - surgery</subject><subject>Mastoidectomy - methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosurgery</subject><subject>Otitis Media, Suppurative - complications</subject><subject>Otitis Media, Suppurative - surgery</subject><subject>Otology</subject><subject>Otorhinolaryngology</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0937-4477</issn><issn>1434-4726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kb2O1TAQhS0EYi8LL0CBXNJk8W-c0KEVf9IiGqgtx55wvUrsYDsLeR06HoF6XwxfslBSWZo555vxHISeUnJBCVEvMiGCyIYw1hDVtrTp7qEDFVw0QrH2PjqQnqtGCKXO0KOcrwkhUvT8ITrjLVVcCH5Avz6YXKJ3OA6TL5BM8THgb74c8XFzKX7fzFJrBfBNvsBDDICX2x_l9if2Ac-7F2yJ84bzmr5A2vACaYxphsoM-GSGUPKOtMc4QS5gqsFgE1ytpBi8reZlWU_TbwDHOs9nXAnevMQGJygp5qWOOXVNMNOWfX6MHoxmyvDk7j1Hn9-8_nT5rrn6-Pb95aurxnKhSmPsKFzX2Y5J2VqlnGhJLwEUZUKBUwPveWd7ZRxXQsphlJwMjjnBiIKup_wcPd-5S4pf17q9nn22ME0mQFyzZor2gvY9k1XKdqmt--YEo16Sn03aNCX6FJneI9M1Mv0nMt1V07M7_jrUL_-z_M2oCvguyLUV6on1dVxTvUL-H_Y3jDKo4w</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Lindeboom, Jantine J.</creator><creator>van Kempen, P. M. W.</creator><creator>Buwalda, J.</creator><creator>Westerlaken, B. O.</creator><creator>van Zuijlen, D. A.</creator><creator>Bom, S. J. H.</creator><creator>van der Beek, F. B.</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2201-4713</orcidid></search><sort><creationdate>20230401</creationdate><title>Mastoid obliteration with hydroxyapatite vs. bone pâté in mastoidectomy surgery performed on patients with cholesteatoma and chronic suppurative otitis media: a retrospective analysis</title><author>Lindeboom, Jantine J. ; van Kempen, P. M. W. ; Buwalda, J. ; Westerlaken, B. O. ; van Zuijlen, D. A. ; Bom, S. J. H. ; van der Beek, F. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-acf4d88c82556c77d46095ee71247ed7b3938c97ad37455bf530bd2d4207e8913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cholesteatoma, Middle Ear - complications</topic><topic>Cholesteatoma, Middle Ear - surgery</topic><topic>Cohort Studies</topic><topic>Durapatite</topic><topic>Head and Neck Surgery</topic><topic>Humans</topic><topic>Mastoid - surgery</topic><topic>Mastoidectomy - methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosurgery</topic><topic>Otitis Media, Suppurative - complications</topic><topic>Otitis Media, Suppurative - surgery</topic><topic>Otology</topic><topic>Otorhinolaryngology</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lindeboom, Jantine J.</creatorcontrib><creatorcontrib>van Kempen, P. M. W.</creatorcontrib><creatorcontrib>Buwalda, J.</creatorcontrib><creatorcontrib>Westerlaken, B. O.</creatorcontrib><creatorcontrib>van Zuijlen, D. A.</creatorcontrib><creatorcontrib>Bom, S. J. H.</creatorcontrib><creatorcontrib>van der Beek, F. B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European archives of oto-rhino-laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lindeboom, Jantine J.</au><au>van Kempen, P. M. W.</au><au>Buwalda, J.</au><au>Westerlaken, B. O.</au><au>van Zuijlen, D. A.</au><au>Bom, S. J. H.</au><au>van der Beek, F. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mastoid obliteration with hydroxyapatite vs. bone pâté in mastoidectomy surgery performed on patients with cholesteatoma and chronic suppurative otitis media: a retrospective analysis</atitle><jtitle>European archives of oto-rhino-laryngology</jtitle><stitle>Eur Arch Otorhinolaryngol</stitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>280</volume><issue>4</issue><spage>1703</spage><epage>1711</epage><pages>1703-1711</pages><issn>0937-4477</issn><eissn>1434-4726</eissn><abstract>Purpose
To compare the efficacy and safety of hydroxyapatite vs. bone pâté as obliteration material in mastoidectomy surgery for patients with chronic suppurative otitis media and cholesteatoma.
Methods
This is a retrospective, multi-center, cohort study. All patients were followed up with micro-otoscopy, audiometry, and, if indicated, MRI with diffusion-weighted imaging. The following outcome parameters were analyzed: procedure safety (wound infections and complications), cholesteatoma recidivism rates (residual/recurrent), control of infection (Merchant’s scale), and hearing results (pure-tone averages at 500/1000/2000/4000 Hz).
Results
Eighty-three cases were included: 45 obliterated with hydroxyapatite and 38 with bone pâté, with a mean follow-up time of, respectively, 25 and 24 months. Wound infections were only detected in the bone pâté group (4.8%) and successfully treated with oral or intravenous antibiotics and surgical drainage (
p
= 0.026). No other major surgical complications were observed in both groups. Cholesteatoma recidivism was observed in 15% using hydroxyapatite and 12% using bone pâté (
p
= 0.471). Complete control of infection (Merchant 0) was achieved in 76.2% using bone pâté and 86.8% using hydroxyapatite at 12 months postoperatively (
p
= 0.223). All patients showed good postoperative healing without complete failure to manage infection (Merchant 3). Pre- and postoperative audiometry showed significant improvement in hearing results in both groups. No significant difference between the obliteration materials was observed.
Conclusions
Evaluation of mastoid obliteration reveals that hydroxyapatite and bone pâté are safe and effective obliteration materials, with high success rates in achieving a dry ear, low recidivism rates, and good hearing outcome, respecting the short-term limitation. In addition, our study shows that hydroxyapatite results in fewer postoperative wound infections compared to bone pâté.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36173443</pmid><doi>10.1007/s00405-022-07661-8</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-2201-4713</orcidid></addata></record> |
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| identifier | ISSN: 0937-4477 |
| ispartof | European archives of oto-rhino-laryngology, 2023-04, Vol.280 (4), p.1703-1711 |
| issn | 0937-4477 1434-4726 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Cholesteatoma, Middle Ear - complications Cholesteatoma, Middle Ear - surgery Cohort Studies Durapatite Head and Neck Surgery Humans Mastoid - surgery Mastoidectomy - methods Medicine Medicine & Public Health Neurosurgery Otitis Media, Suppurative - complications Otitis Media, Suppurative - surgery Otology Otorhinolaryngology Retrospective Studies Treatment Outcome |
| title | Mastoid obliteration with hydroxyapatite vs. bone pâté in mastoidectomy surgery performed on patients with cholesteatoma and chronic suppurative otitis media: a retrospective analysis |
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