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3 results

  • Successful obliteration of troublesome and chronically draining cavities

  • S Geerse, F A Ebbens, M J F de Wolf, E van Spronsen
  • Journal:
    The Journal of Laryngology & Otology / Volume 131 / Issue 2 / February 2017
    Published online by Cambridge University Press:
    10 January 2017, pp. 138-143
    Print publication:
    February 2017
  • Objective:

    This study aimed to evaluate the results of revision radical cavity surgery with mastoid obliteration using a standardised grading scheme.

    Methods:

    A retrospective study was performed of 121 patients (122 ears) with chronically draining ears who underwent revision radical cavity surgery with mastoid obliteration between 2007 and 2013. Surgical indications, patient characteristics, pre- and post-operative Merchant grade, and surgical outcomes were recorded. The main outcome measures were presence of a dry ear, time for complete re-epithelialisation, presence of residual or recurrent disease, and need for revision surgery.

    Results:

    In the 5-year follow-up group (n = 31), dry ears were found in 97 per cent after 6 minor revisions and cholesteatoma-free ears were found in 97 per cent. In the total cohort, dry ears were found in 93 per cent after nine revisions and cholesteatoma-free ears were found in 98 per cent. The median time for complete re-epithelialisation was eight weeks. There were no major complications.

    Conclusion:

    In terms of the dry ear rate, residual cholesteatoma and time to complete epithelialisation, revision radical cavity surgery with mastoid obliteration produces very good results in concordance with published results, despite most patients suffering from very troublesome cavities prior to surgery.

  • Selective laser sintering of polymer biocomposites based on polymethyl methacrylate

  • Rajkumar Velu, Sarat Singamneni
  • Journal:
    Journal of Materials Research / Volume 29 / Issue 17 / 14 September 2014
    Published online by Cambridge University Press:
    27 August 2014, pp. 1883-1892
    Print publication:
    14 September 2014

  • Materials and processes used for medical applications should have specific attributes. For bone repair and reconstruction, controlled open porosity and osteoconductivity are essential apart from mechanical strength and biocompatibility. Several forms of calcium phosphates are often used for these applications, considering properties similar to bone minerals, but often in combinations with other biopolymers. Polymethyl methacrylate (PMMA) and β-tricalcium phosphate (β-TCP) are identified as a suitable combination for the current research, considering specific properties both individually and in combinations, when processed by different means for specific medical applications. Specific responses of the biocomposite material formed by mechanically mixing the two materials in the powder form to selective laser sintering (SLS) under varying conditions are investigated. The results indicate the suitability of the material system for SLS, while controlled porosity and mechanical property combinations are possible by optimizing material composition and process parameters.

  • Bone cement: how effective is it at restoring hearing in isolated incudostapedial erosion?

  • G J Watson, S Narayan
  • Journal:
    The Journal of Laryngology & Otology / Volume 128 / Issue 8 / August 2014
    Published online by Cambridge University Press:
    03 September 2014, pp. 690-693
    Print publication:
    August 2014
  • Objective:

    To determine the effectiveness of biocements in rebridging isolated incudostapedial erosion.

    Methods:

    A review of the use of biocements for isolated incudostapedial joint erosion was performed on publications from 1998 to 2012 available from Medline, Embase and Pubmed. Inclusion criteria were papers published in English, case series or comparative studies with more than 10 patients, isolated incudostapedial erosion through chronic ear disease, minimal air-bone gap less than 20 dB (or air-bone gap less than 10 dB) and follow up for at least one year.

    Results:

    In 108 patients, rebridging ossiculoplasty was performed using hydroxyapatite cement. Closure of air-bone gaps less than 20 dB and less than 10 dB was achieved in 80–94.4 per cent and 29–75 per cent, respectively. Glass ionomer cement was used in 318 patients. Closure of air-bone gaps less than 20 dB and less than 10 dB was achieved in 74–94 per cent and 40–76 per cent, respectively.

    Conclusion:

    Biocements can be successfully used to close isolated incudostapedial erosions. Larger comparative prospective studies documenting the length of eroded incus and types of reformation of the incudostapedial joint, with standardised reporting, are needed in the future.