Regeneration of Mastoid Air Cells in Vivo Using Autologous Cortical Bone

Ken-ichi Kaneko, Shin-ichi Kanemaru, Rie Kanai, Yamada Atsushi

Department of Otolaryngology, Foundation for Biomedical Research and Innovation, Kobe, Japan.
Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Otolaryngology-Head and Neck Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
Department of Radiology, Fukui Red Cross Hospital, Fukui, Japan.

DOI: 10.4236/ss.2012.311102                

Abstract

Purpose: This was a preliminary study to assess surgical construction and regeneration of mastoid air cells in the treatment of cholesteatoma. Methods: Two-stage tympanoplasty with mastoidectomy was performed in four cases of unilateral cholesteatoma with sclerotic mastoid. During the first-stage operation, small fragments of autologous cortical bone were inserted into the cavity after mastoidectomy to form a honeycomb-like structure. Reconstruction of the lateral wall of the mastoid cavity was performed using the mastoid cortical bony plate. Pre- and postoperative mastoid volume was evaluated by three-dimensional reconstruction based on high-resolution computed tomography (HR-CT) images. Results: HR-CT images after the first-stage operation showed that mastoid volume had increased in all subjects. Macroscopic inspection during the second-stage operation revealed that the honeycomb-like structure made of bony fragments and covered by thin mucosa in the mastoid cavity was stable, with no evidence of effusion or granulation tissue. No retraction of the eardrum, middle ear effusion or recurrence of cholesteatoma was observed, and the hearing level on a pure-tone audiogram was improved in any subject 60 - 94 months after the second-stage operation. Conclusion: Surgical construction and regeneration of mastoid air cells using autologous cortical bone can be useful in treatment of cholesteatoma with arrested mastoid pneumatization.

Keywords

Regeneration; Mastoid Air Cells; Mastoid Cortex Plasty; Tissue Engineering; Cholesteatoma

Conflicts of Interest

The authors declare no conflicts of interest.

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