Mastoid obliteration with cryopreserved homologous bone graft

Anna Carolina Fonseca, José Celso Rodrigues de Souza, Eloisa Maria Mello Santiago Gebrim, Luiz Augusto Ubirajara Santos, Ricardo Ferreira Bento
2016 Journal of Laryngology and Otology  
Diagnosis, classification and surgical management of Petrous Bone Cholesteatomas: Gruppo Otologico experience of 200 consecutive patients. Objective: To review the classification and management of Petrous Bone Cholesteatomas (PBCs) at our center and the outcomes of facial nerve (FN) management in these lesions. Study Design: Retrospective study. Setting: A quarternary referral center in Italy for Skull Base pathology. Patients: 200 patients with 201 PBCs were included in the study.
more » ... : All patients diagnosed radiologically to have PBCs were classified according to the Sanna Classification. All patients were surgically treated and followed up with radiology. Main Outcome Measures: Classification of PBCs, surgical approach used, disease control and FN outcomes were analysed. Results: Supralabyrinthine PBCs were the most common type with 92 (45.8%) cases followed by the Massive PBCs with 72 (35.8%) cases. Preservation of pre-operative facial nerve function was highest in the Infralabyrinthine (72.2%) and Infralabyrinthine-apical (73.3%) types. The Transotic Approach was used in 66 (32.8%) cases in this series. The MTCA -Type A was applied in 55 (27.3%) of the cases. An active management of the nerve (re-routing, anastomosis or grafting) was required in 53 (26.4%) cases. Post-operatively, of the 116 cases with FN HB Grade I and II, 107 (92.2%) cases retained the same grade or improved. Recurrence was seen in seven (3.5%) cases. Learning Objectives: Demonstrate that homologous bone graft from a bone bank can be a nonexpensive and easy-touse filler material for mastoid obliteration.
doi:10.1017/s0022215116001572 fatcat:yhw24zgu2nbdroylgy272dmzqq