European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Mastoid obliteration after cholesteatoma surgery with bone substitute mastoid obliteration: A 9-year retrospective experience of 81 cases.
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Defaye Salomé
Аннотация
INTRODUCTION: The aim of this study was to evaluate disease control and functional outcomes of mastoid obliteration using bone substitute material in cholesteatoma surgery.
MATERIAL AND METHODS: This retrospective study included 81 adult patients operated on between March 2014 and March 2023. All patients underwent mastoid obliteration using bone substitute material either during canal wall down cholesteatoma surgery with external auditory canal reconstruction or for rehabilitation of a pre-existing mastoid cavity. Follow-up at 18 months, including otoscopy, audiometry, CT scan and/or MRI, was available for all patients. The STAMCO classification was used to describe disease extension. The mean follow-up duration was 34.5 months (median 28 months; range: 18-112 months).
RESULTS: At the last follow-up visit, 80 patients had a healthy and healed tympanic membrane, while one patient had a persistent perforation. There was no significant difference in mean air conduction pure-tone average before and after surgery (51.8 ± 18.8 dB vs 53.1 ± 21.4 dB, respectively; Wilcoxon test, n=77). Mean air and bone conduction thresholds, as well as the air-bone gap, remained unchanged after surgery. Audiometric outcomes were not influenced by STAMCO classification or by the type of surgery (primary versus revision) in this series. One patient presented with residual cholesteatoma, and no cases of recurrent cholesteatoma were observed.
CONCLUSION: Mastoid obliteration using bone substitute in cholesteatoma surgery achieves favorable anatomical outcomes, a low complication rate, and preservation of hearing. In the absence of a control group, these results support the technique's safety rather than a demonstrated reduction in recurrence, and comparative studies are needed to confirm its benefit on disease control.
MATERIAL AND METHODS: This retrospective study included 81 adult patients operated on between March 2014 and March 2023. All patients underwent mastoid obliteration using bone substitute material either during canal wall down cholesteatoma surgery with external auditory canal reconstruction or for rehabilitation of a pre-existing mastoid cavity. Follow-up at 18 months, including otoscopy, audiometry, CT scan and/or MRI, was available for all patients. The STAMCO classification was used to describe disease extension. The mean follow-up duration was 34.5 months (median 28 months; range: 18-112 months).
RESULTS: At the last follow-up visit, 80 patients had a healthy and healed tympanic membrane, while one patient had a persistent perforation. There was no significant difference in mean air conduction pure-tone average before and after surgery (51.8 ± 18.8 dB vs 53.1 ± 21.4 dB, respectively; Wilcoxon test, n=77). Mean air and bone conduction thresholds, as well as the air-bone gap, remained unchanged after surgery. Audiometric outcomes were not influenced by STAMCO classification or by the type of surgery (primary versus revision) in this series. One patient presented with residual cholesteatoma, and no cases of recurrent cholesteatoma were observed.
CONCLUSION: Mastoid obliteration using bone substitute in cholesteatoma surgery achieves favorable anatomical outcomes, a low complication rate, and preservation of hearing. In the absence of a control group, these results support the technique's safety rather than a demonstrated reduction in recurrence, and comparative studies are needed to confirm its benefit on disease control.