Michigan State University College of Human Medicine, East Lansing, MI, USA.
Michigan Ear Institute, Farmington Hills, MI.
Am J Otolaryngol. 2021 May-Jun;42(3):102933. doi: 10.1016/j.amjoto.2021.102933. Epub 2021 Jan 29.
There have been multiple proposed etiologies of reparative granuloma following stapes surgery. In this report, we present the first case of post-stapedectomy reparative granuloma following the use of Biodesign (Cook Medical, Bloomington, IN) otologic graft material, an acellular matrix derived from porcine small intestinal submucosa, and review the literature of post-stapes surgery reparative granuloma.
50-year-old woman who developed a reparative granuloma following stapedotomy with acellular porcine intestinal submucosa presenting with profound hearing loss and vertigo.
Middle ear exploration with excision of granuloma and revision stapedotomy.
Audiologic outcomes as measured by pure-tone air and bone conduction thresholds and word recognition scores. Improvement in vertigo.
Surgical excision of the reparative granuloma with revision stapedotomy resolved vertigo. Hearing has improved progressively postoperatively.
We report the first case of post-stapedotomy reparative granuloma following the use of acellular porcine intestinal submucosa. Although exact etiology cannot be determined from a single case report, this illustrates the need for careful use of novel foreign graft material. This case additionally confirms that removal of granuloma and inciting materials can salvage serviceable hearing.
镫骨手术后修复性肉芽肿有多种可能的病因。在本报告中，我们首次报道了使用生物设计（库克医疗，布卢明顿，IN）耳科移植物材料（一种源自猪小肠黏膜下层的无细胞基质）后发生镫骨切除术后修复性肉芽肿的病例，并回顾了镫骨手术后修复性肉芽肿的文献。
50 岁女性，在进行镫骨切开术时使用了无细胞猪肠黏膜下层移植物，术后出现了修复性肉芽肿，表现为严重听力损失和眩晕。
中耳探查，切除肉芽肿并进行镫骨成形术翻修。
纯音空气和骨导阈值以及言语识别得分的听力结果。眩晕改善。
通过手术切除修复性肉芽肿并进行镫骨成形术翻修，解决了眩晕问题。术后听力逐渐改善。
我们报告了首例使用无细胞猪肠黏膜下层移植物后发生的镫骨切开术后修复性肉芽肿。尽管不能从单个病例报告中确定确切的病因，但这说明了需要谨慎使用新型异种移植物材料。该病例还证实，切除肉芽肿和引发材料可以挽救可利用的听力。
