Result of Mastoid Obliteration According to the Graft Materials: Autogenous Bone, Allogeneic Bone, Hydroxylapatite

were compared, and their compatibility as mastoid obliteration materials was examined. Materials and Methods: Among patients performed mastoid obliteration during the first surgery or revision for otitis media or cholesteatoma from January 2007 to April 2010, 191 patients, 196 ears, whose follow-up observation period was longer than 6 months were selected. The male was 72 patients (74 ears), and the female was 119 patients (122 ears). The age distribution was 9 78 years, and the mean age was 45.5 years. The follow-up observation period was average 15 months. Used for mastoid obliteration surgery were autogenous bone, allogeneic bone and hydroxylapatite (HA) and we divided patients into three groups according to graft materials. The rate of graft failure and complications were examined. Complications were divided into mastoid and tympanic cavity complications. Results: The rate of graft failure in HA group was highest in both CWU and CWD surgery. In autogenous bones group was 0.8 %, which was lowest and allogeneic bone group, it was 3.1 %, and good results comparable to autogenous bone group. In regard to mastoid and tympanic cavity complication, HA group also showed highest rate (10% and 16.7% respectively). Conclusion: In mastoid obliteration, HA was high rate of graft failure and complications. Thus it was determined to be not compatible any more. In contrast, allogeneic bone hardly induced problems comparable to autogenous bone. Therefore, it is judged that for cases whose autogenous bone for mastoid obliteration is not sufficient or available, allogeneic bones could be used as safe substitute materials.

[1]  M. Kang,et al.  Histologic Serial Changes of Obliterating Materials in the Rat Temporal Dorsal Bullae , 2009 .

[2]  H. Pau,et al.  Experimental Studies on a New Highly Porous Hydroxyapatite Matrix for Obliterating Open Mastoid Cavities , 2008, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[3]  Won-Sang Lee,et al.  A Case of Repair of Retroauricular Skin Defect and Mastoid Cavity with Posterior Wall Reconstruction Using $Tutoplast^{\circledR}$ (Allograft Cancellous Bone Chip) and Bone Dust after Canal Wall Down Mastoidectomy , 2008 .

[4]  H. Park,et al.  Histopathologic Evaluation of Obliterating Materials in the Temporal Dorsal Bullae of Rat , 2007 .

[5]  Y. Ducic,et al.  Hydroxyapatite Cement in Craniofacial Reconstruction , 2005, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[6]  M. Yung,et al.  Mastoid Obliteration with Hydroxyapatite Cement: The Ipswich Experience , 2004, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[7]  J. Dornhoffer,et al.  The Use of Demineralized Bone Matrix for Mastoid Cavity Obliteration , 2004, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[8]  R. Kotz,et al.  Faster integration of human allograft bone than of the bovine substitute LubbocNon-randomized evaluation of 20 cases with benign tumors or tumorlike conditions , 2004, Acta orthopaedica Scandinavica.

[9]  J. Dornhoffer,et al.  Canal Wall Reconstruction with Mimix Hydroxyapatite Cement: Results in an Animal Model and Case Study , 2003, The Laryngoscope.

[10]  J. Phillips,et al.  A Contraindication for the Use of Hydroxyapatite Cement in the Pediatric Population , 2002, Plastic and reconstructive surgery.

[11]  J M Neigel,et al.  Use of Demineralized Bone Implants in Orbital and Craniofacial Reconstruction and a Review of the Literature , 1996, Ophthalmic plastic and reconstructive surgery.

[12]  C. Friedman,et al.  Indications for hydroxyapatite cement reconstruction in lateral skull base surgery. , 1995, The American journal of otology.

[13]  Rod J. Rohrich,et al.  Frontal sinus obliteration: a comparison of fat, muscle, bone, and spontaneous osteoneogenesis in the cat model. , 1995, Plastic and reconstructive surgery.

[14]  R. Gray,et al.  Mastoid obliteration using bone pâté. , 1994, Clinical otolaryngology and allied sciences.

[15]  M. Brough,et al.  Mastoid obliteration with the temporoparietal fascia flap , 1991, The Journal of Laryngology & Otology.

[16]  V. Lund,et al.  Prostaglandin synthesis in the pathogenesis of fronto-ethmoidal mucoceles. , 1987, Acta oto-laryngologica.

[17]  W. Meuser The exenterated mastoid: a problem of ear surgery. , 1985, The American journal of otology.

[18]  J. Sadé Treatment of retraction pockets and cholesteatoma , 1982, The Journal of Laryngology & Otology.

[19]  K. Takagi,et al.  A bovine low molecular weight bone morphogenetic protein (BMP) fraction. , 1982, Clinical orthopaedics and related research.

[20]  M. E. Simpson,et al.  Mastoid obliteration using homogenous bone chips and autogenous bone paste. , 1972, Transactions - American Academy of Ophthalmology and Otolaryngology. American Academy of Ophthalmology and Otolaryngology.

[21]  J. L. Turner Obliteration of mastoid cavities by musculoplasty , 1966 .

[22]  E. Fornatto,et al.  The fat graft in middle ear surgery. , 1962, Archives of otolaryngology.

[23]  H. P. Mosher A method of filling the excavated mastoid with a flap from the back of the auricle , 1911 .