Figure - available from: Laryngoscope Investigative Otolaryngology
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Axial view of the mastoid cavity, silicone block was covered by large temporalis fascia. 1. Silastic sheet, 2. Temporalis fascia, 3. Silicone block, 4. Anterior wing, 5. Bony ridge, 6. Posterior wing, 7. Sigmoid sinus
Source publication
Objective
To prevent cavity problems in canal wall down mastoidectomy, silicone block for mastoid obliteration was used.
Methods
In this retrospective cohort study, 39 patients (21 males and 18 females) underwent canal wall down mastoidectomy and mastoid obliteration using silicone block. We evaluated the postoperative outcome, the time until epit...
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Objective
This systematic review aims to describe the impact of otologic surgery as a treatment for chronic otitis media (COM) on the Health-Related Quality of Life (HRQoL) of adult patients.
Methods
A literature search was performed in PubMed, Scopus, Embase, and Web of Science until May 2023. Prospective studies including adult patients with COM...
Tinnitus is a symptom of an underlying condition that can be neurological, ontological, or infectious in origin. This case report describes a patient with pulsatile tinnitus caused by sigmoid sinus dehiscence, which was successfully treated by sigmoid sinus dehiscence repair. We recommend computed tomography angiography/magnetic resonance angiograp...
Objectives: Chronic otitis media (COM) remains a global disease, a burden, and a challenge. Predicting its treatment’s postoperative success based on clinical presentation has not been reported, particularly for the mucosal (tubotympanic/safe) type.
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Background
There are still many questions about the pathogenesis of chronic suppurative otitis media (CSOM) and consequently about the optimal management medical or surgical interventions. Many otolaryngologists continue to routinely perform mastoidectomy with tympanoplasty, arguing that surgical aeration of the mastoid will improve outcomes by pro...
Citations
... The data regarding predisposing factors, associations, etiology, and treatment are scarce. CWD procedure secondary to cholesteatoma or other chronic ear conditions could cause GT with varying reported rates of 9-57.7% [3][4][5][6][7]. We found no estimation of GT occurrence in ICW and stapes surgery; however, more limited surgical interventions like tympanostomy tube placement may also be complicated with GT in 5-13.8% of patients [8,9]. ...
Background
Granulation tissue (GT) formation is a complication of otologic surgeries. We aimed to assess the rate of GT formation following these procedures and their outcome.
Methods
This cross-sectional study was performed from 2015 to 2019. Patients who underwent tympanomastoidectomy (either CWD or ICW) and stapedotomy were included. Demographic and other related data were gathered. Four weeks after surgery, patients were assessed for any sign of granulation tissue formation. If present, they were managed topically and were followed every 2 months until complete resolution.
Results
Of 1045 included cases, 200 underwent Canal Wall Down (CWD) mastoidectomy, 568 underwent Intact Canal Wall (ICW) mastoidectomy, and 277 experienced stapedotomy. Four weeks after surgery, 180 participants were diagnosed with GT (17.22%). The incidence rate of GT formation following tympanomastoidectomy and stapedotomy is 23.44% and 0%, respectively. This measure is 43% and 16.5% for CWD, and ICW approaches. Following treatment for 2 months, we found 164 (91.1%) participants with complete resolution at the second visit. Of the remaining 16 cases, 10 and 6 were cured at the third and fourth visits. Males developed GT significantly more ( p < 0.001).
Conclusion
Those with CWD mastoidectomy are more likely to develop GT than ICW and stapedotomy surgeries. It has a favorable response to conservative topical management.
... The pore size and intercommunication of scaffolds are other important factors affecting their biological properties, such as promoting the migration and proliferation of cells, facilitating the infiltration of blood vessels, improving the local nutritional and metabolic environment, and accelerating the process of bone repair [16e18]. Considering the influence of the size of the new blood vessels and the diameter of the new bone Haver's canal, the academic community generally believes that a minimum pore diameter of <100 mm is unfavorable for the ingrowth of blood vessels and the formation of new bone [19,20]. The transverse and longitudinal meridians of the S53P4/PCL scaffolds fabricated in this study were all >100 mm, the fibers inside the scaffolds were well organized, and the pores of each layer were interconnected, which was fully beneficial to cell migration, blood vessel growth, and new bone formation. ...
Introduction
The lack of good prosthetic materials and objective standards has limited the promotion of mastoid obliteration and external auditory canal reconstruction, and the quality of the surgery varies. In this study, bioactive glass S53P4 (S53P4), the most popular artificial prosthetic material, was modified and combined with polycaprolactone (PCL) and bone morphogenetic protein-2 (BMP-2) to produce an individualized biological scaffold using 3D printing technology to explore a better material and method for mastoid obliteration and external auditory canal reconstruction.
Methods
3D-printed S53P4/PCL scaffolds were fabricated from 3D reconstruction data of bone defect areas in New Zealand rabbits simulating “Canal Wall Down Mastoidectomy”. The water absorption, swelling rate, porosity, and Young's modulus of the scaffold were measured, and the morphology and pore size of the scaffold were observed using scanning electron microscopy. The cytotoxicity of the S53P4/PCL scaffolds was detected using the CCK8 assay, and the in vitro antibacterial activity of the S53P4/PCL scaffolds was detected using the inhibition circle method. The BMP-2-loaded S53P4/PCL scaffolds were prepared using the drop-in lyophilization method and implanted into animal models. The biocompatibility, osteogenic activity, and external auditory canal repair of the scaffolds were observed using endoscopy, micro-CT, and histological examination.
Results
The S53P4/PCL scaffold was highly compatible with the defective area of the animal model, and its physicochemical properties met the requirements of bone tissue engineering. In vitro experiments showed that the S53P4/PCL scaffold was non-cytotoxic and exhibited better antibacterial activity than the same volume of the S53P4 powder. In vivo experiments showed that the S53P4/PCL scaffold had good biocompatibility and osteogenic activity, and could effectively repair bone defects and reconstruct the normal morphology of the external auditory canal in animal models. Furthermore, its osteogenic activity and repair ability were significantly improved after loading with BMP-2.
Conclusions
The 3D printed S53P4/PCL scaffold has great potential for clinical mastoid obliteration and external auditory canal reconstruction.
