Materials used for mastoid obliteration and its complications: a systematic review

Choong, KWK; Kwok, MMK; Shen, Y; Gerard, JM; Teh, BM

Author(s): Choong, KWK; Kwok, MMK; Shen, Y; Gerard, JM; Teh, BM;
Details: Publication Year 2022-05,Volume 92,Issue #5,Page 994-1006
Journal Title: ANZ Journal of Surgery
Publication Type: Review
Abstract: OBJECTIVE: The objectives of this review are to identify the types of materials with their associated complications and respective considerations when used to obliterate the mastoid cavity. METHODS: A systematic search was performed across PubMed, Embase, Medline and Cochrane databases from January 2009 to January 2020 for randomized controlled trials and observational studies of patients that underwent mastoid obliteration. Studies that fulfilled the inclusion criteria were screened and scored according to the MINORS and relevance scores to determine final inclusion. Types of complications were grouped into minor and major complications based on the Clavien-Dindo classification. RESULTS: Two thousand five hundred and seventy-eight ears were evaluated. There were a total of 165 (7.9%) minor and 142 (6.8%) major complications in the autologous group. Overall complication rate is 14.8%. The major complications were largely recurrent and residual disease requiring revision surgery. There were 10 (18.5%) minor complications and three (5.6%) major complications in the allogenic group. The cumulative complications risk is 24%. For the synthetic group, there were 39 (8.0%) minor and 34 (7.6%) major complications. The cumulative complication rate is 16.6%. CONCLUSION: Current evidence on materials for mastoid obliteration has been evolving. Each material has its strengths and limitations. The trend over the last decade favours the use of autologous materials. The principle of using a material remains being cautious of not reimplanting skin that can lead to the development of a cholesteatoma. The choice of materials is dependent on patient factors as well as the surgeons' preference and experience.
Keywords: *Cholesteatoma, Middle Ear/surgery; Humans; *Mastoid/surgery; Reoperation; Retrospective Studies; Transplantation, Autologous; allogenic materials; autologous materials; biological materials; complication; mastoid obliteration; synthetic materials
Department(s): Surgical Oncology
PubMed ID: 35191151
Publisher's Version: https://doi.org/10.1111/ans.17563
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-16 06:19:38

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