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Titolo:
Surgical repair of bone defects of the ear canal wall with flexible hydroxylapatite sheets: A pilot study
Autore:
Zanetti, D; Nassif, N; Antonelli, AR;
Indirizzi:
Univ Brescia, Dept Otolaryngol, Brescia, Italy Univ Brescia Brescia Italy iv Brescia, Dept Otolaryngol, Brescia, Italy
Titolo Testata:
OTOLOGY & NEUROTOLOGY
fascicolo: 6, volume: 22, anno: 2001,
pagine: 745 - 753
SICI:
1531-7129(200111)22:6<745:SROBDO>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
ORBITAL IMPLANTS; MIDDLE-EAR; MASTOIDECTOMY RECONSTRUCTION; HYDROXYAPATITE; CHOLESTEATOMA; TYMPANOPLASTY; MANAGEMENT; EXPERIENCE; SURGERY;
Keywords:
outer ear canal wall reconstruction; flexible hydroxylapatite; chronic otitis media; cholesteatoma;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
66
Recensione:
Indirizzi per estratti:
Indirizzo: Zanetti, D Univ Brescia, Clin Otorinolaringoiatrica, Piazzale Spedali Civili 1, I-25100 Brescia, Italy Univ Brescia Piazzale Spedali Civili 1 Brescia Italy I-25100 y
Citazione:
D. Zanetti et al., "Surgical repair of bone defects of the ear canal wall with flexible hydroxylapatite sheets: A pilot study", OTOL NEURO, 22(6), 2001, pp. 745-753

Abstract

Objective: Evaluation of suitability of flexible composite sheets (hydroxylapatite and polymer) for outer ear canal (OEC) wall reconstruction in tympanoplasty. Study Design: Prospective, open label pilot study. Setting: University and regional hospital. Patients: Forty-two randomly selected patients with chronic otitis media (n = 20) and cholesteatoma (n = 22) among 356 patients admitted between 1996and 1997. Interventions: Eradication of disease through a partial or total canal wall down mastoidectomy; immediate reconstruction of canal wall with flexible composite sheet (hydroxylapatite and polymer) and connective tissue graft. Outcome Measures: Anatomic integrity of the OEC and neotympanum, extrusionrate, complications. Results: At minimum follow-up of 24 months: recurrent cholesteatoma (n = 0), residual cholesteatoma (n = 3/22) (13.6%) in the mesotympanum (none behind the hydroxylapatite sheet or in the attic or antrum). The neotympanum was intact in 38 ears (90.4%), reperforated in 2, and severely retracted and lateralized in 1, respectively. Anatomic integrity of the OEC was obtained in 37 (88%) of 42 patients, stenosis or membranous synechiae were observed in 5 ears and treated in the office. Extrusion of the hydroxylapatite sheetoccurred in 7 patients (16.6%) because of purulent otorrhea and granulation tissue formation. Surgical revision achieved complete epithelialization of the rebuilt canal wall in 33 ears (78.6%). Conclusions: A dry, disease-free ear and normal anatomy may be expected 2 years postoperatively in more than three-fourths of the patients treated using the described surgical technique. Complete protection with a connectivetissue graft is essential to avoid extrusion of the implant. The failure rate is significantly higher if otorrhea is present at the time of the operation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/02/20 alle ore 02:17:04