S53P4 生物活性玻璃的结果和并发症的多中心回顾性病例研究
A Multicenter Retrospective Case Review of Outcomes and Complications of S53P4 Bioactive Glass.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, Belfast, Northern Ireland.
Department of Otolaryngology-Head and Neck Surgery, Craigavon Area Hospital, Craigavon, Northern Ireland.
出版信息
J Int Adv Otol. 2021 May;17(3):234-238. doi: 10.5152/iao.2021.9053.
OBJECTIVE
The objective of this multicenter retrospective case review was to assess the natural clinical course, efficacy, and safety of mastoid obliteration with S53P4 Bioactive Glass (bioactive glass).
METHODS
Retrospective case note review in a regional Tertiary Referral Centre and District General Hospital. Patients undergoing mastoid cavity obliteration as part of primary or secondary procedure with bioactive glass between 2012 and 2018. Outcome measures were assessed from a prospectively collated database and case note review. Primary outcomes were the common morbidities of a mastoid cavity; dry or discharging ear (Merchant's scale), vertigo in cold air, and a watertight middle ear. Patients were also assessed for audiological outcomes and recidivism.
RESULTS
Ninety patients were included. During the follow-up period, (mean, 22 months; range, 6-59 months) cholesteatoma recidivism was observed in 2% of ears (2 patients). An acceptably dry (Merchant Grade 0-1) ear was achieved in 91% of all ears (95% primary cases, 80% secondary cases). Delayed healing of the graft in the external ear canal retaining the S53P4BAG Bioactive Glass (BonAlive Ò (BonAlive Ò Biomaterials Ltd., Turku, Finland)) within the mastoid occurred in 13% (12 ears). However, in all cases, conservative management resulted in complete healing.
CONCLUSIONS
Bioactive glass provides a safe and effective means of mastoid obliteration. Complications including overlay graft failure and slow epithelialization, resulting in prolonged postoperative discharge (up to 2 months) and dehiscence into the external ear canal, do not preclude full recovery and may be successfully managed conservatively.
目的
本多中心回顾性病例研究的目的是评估 S53P4 生物活性玻璃（生物活性玻璃）乳突填塞的自然临床病程、疗效和安全性。
方法
在区域三级转诊中心和地区综合医院进行回顾性病历审查。在 2012 年至 2018 年间，对接受生物活性玻璃作为原发性或继发性手术一部分进行乳突腔填塞的患者进行回顾性评估。从前瞻性收集的数据库和病历审查中评估结果测量指标。主要结果是乳突腔的常见并发症；干性或渗出性耳（Merchant 分级）、冷空气性眩晕和密闭性中耳。还评估了患者的听力结果和复发情况。
结果
共纳入 90 例患者。在随访期间（平均 22 个月；范围 6-59 个月），观察到 2%的耳朵（2 例）发生胆脂瘤复发。所有耳朵（95%原发性病例，80%继发性病例）中，可接受的干性耳（Merchant 分级 0-1）的比例达到 91%。S53P4BAG 生物活性玻璃（BonAlive®（BonAlive®生物材料有限公司，图尔库，芬兰））保留在外耳道中的移植物在乳突内的愈合延迟发生在 13%（12 只耳朵）。然而，在所有情况下，保守治疗均导致完全愈合。
结论
生物活性玻璃为乳突填塞提供了一种安全有效的方法。并发症包括覆盖移植物失败和上皮化缓慢，导致术后分泌物延长（长达 2 个月）和向外耳道裂开，但不会妨碍完全恢复，且可以成功保守治疗。
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