gms | German Medical Science

Introduction: An open mastoid cavity might lead to various problems for the patient. Chronic inflammation of the cavity with secretion, changes in the acoustic behavior, vertigo in restricted situations and an impaired self-cleaning function with increased ear wax might affect the patient. For surgical treatment numerous techniques for reconstructing of the outer ear canal or at least reducing of the size of such cavities have been described. Besides autologous materials such as hydroxyapatite or alloplastic substances as tricalcium phosphate have been previously used. A very slow resorption of these materials with rejection has been described. The new ceramic NanoBone^®, which was already successfully used for sinus lift in maxillofacial surgery, was fabricated in a sol-gel process at 700°C depositing unsintered hydroxylapatite in a SiO2 structure. This method provides a nano/microstructure of high porosity of the resulting matrix.

Method: 20 patients were reexamined after an average of 2 years and five months after obliteration of the open mastoid cavity with NanoBone®. We compared pre- and postoperative findings in terms of otorrhea, frequency of medical consultation, vertigo and otoscopic findings. In 5 patients, in addition, a postoperative CT scan of the temporal bones was used for evaluation of osteoinduction and osteointegration.

Results: After obliteration of the open mastoid cavity with NanoBone^® we observed an uneventfully healing. After surgery we achieved a reduction of vertigo, otorrhea and frequency of medical consultations for the single patient.

Conclusion: The obliteration of an open mastoid cavity with NanoBone^® is a safe alternative method relative to the surgical techniques with autologous materials.