The use of demineralized bone matrix for mastoid cavity obliteration.

OBJECTIVE

To evaluate the use of demineralized bone matrix as a graft material for mastoid cavity obliteration in the treatment and prevention of problematic mastoid cavities.

STUDY DESIGN

The study is a retrospective review of patients identified using a computerized otology database.

SETTING

Tertiary care referral center.

PATIENTS

Patients were included in this study if they underwent mastoid obliteration using demineralized bone matrix.

INTERVENTION

Mastoid obliteration was performed for revision of a problematic mastoid cavity (n = 8) or primarily after canal wall down mastoidectomy for recurrent cholesteatoma (n = 3).

MAIN OUTCOME MEASURES

Data were collected to evaluate the ability to achieve a dry ear canal. Postoperative healing time and hearing results were also assessed.

RESULTS

A dry ear canal was achieved in all patients with a follow-up of 6 to 20 months (average, 14.5 mo). Eight patients (73%) had a well-healed, dry ear canal by their first postoperative visit (9 wk). One patient required 12.5 weeks to heal. Two patients (18%) had more prolonged granulation at the ear canal incision, which resolved in 17 and 28 weeks, respectively. The average preoperative pure-tone average air-bone gap was 47 +/- 14.9 dB (mean +/- SD), compared with postoperative values of 27.6 +/- 12.8 dB (p = 0.0033; paired t test). This represents an average pure-tone average air-bone gap closure of 20 dB.

CONCLUSION

The use of demineralized bone matrix as a graft extender in mastoid obliteration allowed creation of a dry, smooth-contoured canal in all patients studied. A significant improvement in hearing was also obtained. Demineralized bone matrix is an acceptable graft alternative for mastoid obliteration.