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Performance of ionomeric cement (Ionocem®) in the reconstruction of the posterior meatal wall after curative middle-ear surgery

Published online by Cambridge University Press:  29 June 2007

G. Geyer ,
S. Dazert  and
J. Helms
G. Geyer*
Affiliation:
Department of Otolaryngology, Municipal Hospital Solingen, Germany.
S. Dazert
Affiliation:
Department of Otolaryngology, University of Wuerzburg, Germany.
J. Helms
Affiliation:
Department of Otolaryngology, University of Wuerzburg, Germany.
*
Address for correspondence: Priv.-Doz. Dr G. Geyer, ENT Department, Municipal Hospital, Gotenstr. 1, 42653 Solingen, Germany. Fax: 0212-5472670
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Abstract

The hybrid bone-substitute ionomeric cement is suitable for restoring the original anatomy of the posterior canal wall. During a four-year period the posterior meatal wall was rebuilt with ionomeric cement in 74 patients. The canal wall was totally rebuilt in38 patients, two-thirds rebuilt in 22 cases, and one-third rebuilt in14 cases. On the meatal side, the canal wall was covered by a musculo-periosteal (Palva) flap. In the majority of cases, the drum was closed with (cartilage)-perichondrium. Revisions were performed in 27 patients (due partially to cholesteatoma, and/or poor visualization of radical mastoidectomy cavities). The ears were non-infected at thetime of operation.

Permanent epithelialization of the bone replacement material was achieved in 57 cases, with secondary closure of a cutaneous defect of the meatal wall being required in six cases. The auditory canal wall had to be removed in 17 patients owing to deficient soft-tissue coverage, persistent inflammation, and/or partial adhesive processes with development of cholesteatoma. In terms of surgical technique, utilization of the material over a follow-up period of maximally seven years proved it to be a sophisticated procedure for reconstructing themeatal wall. Despite the finesse of the surgical technique employed, the overall failure rate of 31 per cent was inadmissibly high. Implantation of the material should therefore be restricted to middle ears with permanent ventilation and no trace of infection.

Keywords

Ionomeric cementBone cementsMastoid, surgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 12 , December 1997 , pp. 1130 - 1136
Copyright
Copyright © JLO (1984) Limited 1997

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