A Multicentre Retrospective Case Review of Outcomes and Complications of
S53P4 Bioactive Glass in Mastoid Obliteration Surgery.
Objective The objective of this multicentre retrospective case review
was to assess the natural clinical course, efficacy and safety of
Mastoid Obliteration with S53P4 Bioactive Glass (bioactive glass). Study
Design Retrospective case note review Setting Regional Tertiary Referral
centre and District General Hospital Participants Patients undergoing
mastoid cavity obliteration as part of primary or secondary procedure
with bioactive Glass between 2012 – 2018. Outcome measures were
assessed from a prospectively collated database and case note review.
Main Outcome Measures Primary outcomes were the common morbidities of a
mastoid cavity; dry or discharging ear (Merchant’s scale), vertigo in
cold air and a water tight middle ear. Patients were also assessed for
audiological outcomes and recidivism. Results 90 patients were included.
During the follow up period, (mean = 22 months; range = 6 - 59 months)
cholesteatoma recidivism was observed in 2% of ears, (2 patients). An
acceptably dry (Merchant Grade 0 – 1) ear was achieved in 91% of all
ears (95% Primary Cases, 80% Secondary Cases). Delayed healing of the
graft in the external ear canal retaining the S53P4BAG Bioactive Glass
(BonAlive,(BonAlive Biomaterials Ltd., Turku, Finland)) within the
mastoid occurred in 13% (12 ears). However, in all cases conservative
management resulted in complete healing. Conclusions Bioactive glass
provides a safe and effective means of mastoid obliteration.
Complications including overlay graft failure and slow epithelisation
resulting in prolonged postoperative discharge (up to 2 months) and
dehiscence into the external ear canal do not preclude full recovery and
may be successfully managed conservatively.