Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2025
Does Mastoid and Epitympanic Obliteration With S53P4 Bioactive Glass Reduce Cholesteatoma Recidivism in Canal-Wall-Up Surgeries? A Retrospective Clinical Study.
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Delille Hugo, Bernardeschi Daniele, Di Bari Matteo, Sterkers Olivier, Tankéré Frédéric, Lahlou Ghizlène, Alciato Lauranne
Аннотация
OBJECTIVE: The aim of this study was to compare canal-wall-up tympano-mastoidectomy with or without mastoid and epitympanic obliteration, and to estimate the 5-year recidivism rate using Kaplan-Meier survival analysis.
STUDY DESIGN: Retrospective cohort study.
PATIENTS: One hundred seventy-two consecutive ears with a diagnosis of cholesteatoma who underwent canal-wall-up tympano-mastoidectomy with or without obliteration with S53P4 bioactive glass granules (S53P4 and NO group) from January 2008 to December 2019.
INTERVENTION: BAG obliteration.
SETTING: Single-center study in a tertiary referral center.
MAIN OUTCOME MEASURE: Cholesteatoma recidivism, recurrent and residual disease.
RESULTS: In our population, cholesteatoma recidivism rate was 18% in the NO group and 5% in the S53P4 group (P < 0.01). The overall cholesteatoma-free survival rate at 5 years, calculated with the log-rank test for survival analysis, was 87.8% (95% CI, 77.8-99) in the S53P4 group and 58.2% (95% CI, 42.6-79.5) in the NO group (P < 0.01). The recurrent cholesteatoma-free survival rate at 5 years was 89% (95% CI, 79.1-100) in the S53P4 group and 65.8% (95% CI, 49.4-87.6) in the NO group. Recurrent disease significantly differed between the two groups (P = 0.018).
CONCLUSION: Mastoid and epitympanic obliteration using S53P4 bioactive glass significantly reduced the recurrence of cholesteatoma in patients undergoing canal-wall-up tympano-mastoidectomy. These findings suggest a potential benefit of obliteration when mastoidectomy is required.
STUDY DESIGN: Retrospective cohort study.
PATIENTS: One hundred seventy-two consecutive ears with a diagnosis of cholesteatoma who underwent canal-wall-up tympano-mastoidectomy with or without obliteration with S53P4 bioactive glass granules (S53P4 and NO group) from January 2008 to December 2019.
INTERVENTION: BAG obliteration.
SETTING: Single-center study in a tertiary referral center.
MAIN OUTCOME MEASURE: Cholesteatoma recidivism, recurrent and residual disease.
RESULTS: In our population, cholesteatoma recidivism rate was 18% in the NO group and 5% in the S53P4 group (P < 0.01). The overall cholesteatoma-free survival rate at 5 years, calculated with the log-rank test for survival analysis, was 87.8% (95% CI, 77.8-99) in the S53P4 group and 58.2% (95% CI, 42.6-79.5) in the NO group (P < 0.01). The recurrent cholesteatoma-free survival rate at 5 years was 89% (95% CI, 79.1-100) in the S53P4 group and 65.8% (95% CI, 49.4-87.6) in the NO group. Recurrent disease significantly differed between the two groups (P = 0.018).
CONCLUSION: Mastoid and epitympanic obliteration using S53P4 bioactive glass significantly reduced the recurrence of cholesteatoma in patients undergoing canal-wall-up tympano-mastoidectomy. These findings suggest a potential benefit of obliteration when mastoidectomy is required.