New indications for the use of bioactive glass (S53P4 – Bonalive^®) in middle ear surgery

In the last couple of years S53P4 (BonAlive^®) has established as material for obliteration of radical cavities. At ENT department in Halberstadt S53P4 has been used in more than 250 cases. The initial focus was on obliteration of open mastoid cavities and in combination with VSB- or Cochlear Implantation. Meanwhile, S53P4 is also used in chronic mastoiditis and in cholesteatoma surgery in CWU technique.

Since 2018 a total number of 41 operations have been performed in these cases. The focus is now on CWU surgery in cases of extended cholesteatoma. 28 operations where performed under this indication so far. 6 patients underwent obliteration due to chronic mastoiditis and 1 patient was obliterated bilaterally in case of granular mastoiditis concerning mantle cell lymphoma. The average follow up-time is 12 months (0 – 42 month).

For 23 patients after cholesteatoma surgery follow up-results are available. There is no evidence for recurrent cholesteatoma, the tympanic membrane is intact in all 3 cases, there is no epitympanic retraction visible. 2 patients are lost to follow up. 3 patients out of 5 who received an obliteration in chronic mastoiditis are symptom-free. One patient received a T-Tube because of recurrent effusion. In this case a complete traumatic closure of the epipharyngeal tube ostium is present. In 1 case the bioactive glass was explanted because of chronic inflammation.

Due to its antibacterial properties, S53P4 is suitable as alloplastic material in middle ear surgery. When used properly, atelectasis of the tympanic membrane can be prevented. Further investigations are indicated.

A treatment regime for patients with Bonalive^® obliteration of the mastoid in cholesteatoma will be established.

Poster-PDF A-1174.pdf

Publication History

Article published online:
13 May 2021