Prospective Study of the Mastoid Plasties Using Resorbable Bioceramic MBCP® in Surgery of Cholesteatoma

Tympanoplasty is the reference for cholesteatoma treatment in ear, nose, and throat (ENT surgery), with the realization of a closing technique, which preserves the external auditory canal. An insufficient pneumatisation is an element favoring the occurrence and recurrence of cholesteatoma. In a prospective clinical pilot study, we have realized the reconstruction of the mastoid cortical bone by a Micro Macroporous Biphasic Calcium Phosphate bioceramics disks (MBCPTM Biomatlante France) using the closed technique, in order to maintain or increase the mastoid pneumatisation. Eleven patients were used for this study, and some of them have a sample collection for histomorphometry and histopathological analysis. Bone regeneration at the expense of the bioceramic was observed. The size and shape of the disk was not preserved due to the large resorption and bone ingrowth at the expense of the implant. However 6 patients presented cholesteatoma recurrence. The MBCPTM disks are able to reconstruct the mastoid cortical and maintain the mastoid pneumatisation contrarily to the technique of filling the mastoid cavity. However, the high rate of cholesteatoma recurrence observed in our study, confirmed the interest to fill mastoid that suppress airspace posterior cavities.