Use of bioactive glass S53P4 Bonalive​ after ear surgery in chronic otitis media to supply with implantable hearing systems (VSB, CI)

Introduction In case of open mastoid cavities (MC) there is a problem with the safe covering of the electrodes if it is necessary to supply with an implantable hearing system (CI, VSB) in order to avoid electrode extrusion and/or infection of the implants.

Material and Methods Since 2014 S53P4 has been used in our clinic in 77 operations (OPs) on 58 patients in connection with CI or VSB implantation. The average age of the patients at the time of the OP was 59,3 years. 32 pat. were males und 26 females. Simultaneous obliteration of the open MC and implantation with CI was performed in 25 cases and with VSB in 12 cases. 16 patients were implanted via an endaural (CI) and 19 patients via a retroauricular incision (12 x VSB, 9 x CI). Planned two-step surgeries (1st OP was to obliterate the MC with S53P4 and 2nd OP was to implant VSB or CI) were carried out in 13 cases with CI- and in 8 cases with VSB- implantation. An endaural approach was used on 2 patients (CI) and a retroauricular incision was used on 19 patients (11 x CI, 8 x VSB). 19 patients had to be revised. 14 revisions of 25 surgeries were performed in case of one-stage MC- obliteration and CI- implantation, 2 revisions of 13 OPs in case of two-stage CI- implantation after MC-obliteration. In the case of VSB implantations the number of revisions after one-step (2 revisions of 12 OPs) and two-step surgeries (1 revision of 8 OPs) was at a similar level.

Summary S53P4 has proven to be a very good material for obliterating the open MC. Moreover, this especially applies for supplying with hearing implants. We recommend a retroauricular two-step CI -OPs after MC-obliteration with S53P4 from our experience. In VSB cases, a one-stage OP may also be possible. Revision interventions can be carried out without difficulties.

Publication History

Article published online:
12 May 2023