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Electrocoagulation improving bone cement use in middle-ear surgery: short-term and middle-term results

  • C Galy-Bernadoy (a1), M Akkari (a1), M Mondain (a1) (a2), A Uziel (a1) (a2) and F Venail (a1) (a2)...

Abstract

Background:

Bone cement is used for ossicular chain repair and revision stapes surgery. Its efficient use requires cautious removal of mucosa from the ossicles. This paper reports a technique for easy, fast and safe removal of this mucosa prior to cement application. It consists of the application of monopolar electrocoagulation on the ossicles prior to bone cement application.

Methods:

The outcomes of six cases of revision stapes surgery and seven cases of partial ossiculoplasty, conducted between 2007 and 2012 using this new technique, were evaluated. Intra-operative reports and audiometric data were collected.

Results:

During the last assessment, reconstruction using bone cement resulted in mean post-operative air–bone gaps of 4.1 ± 6.5 dB in revision stapes surgery cases and 5.7 ± 5.5 dB in partial ossiculoplasty cases, reflecting a significant hearing improvement (p = 0.03). No complications were observed.

Conclusion:

Electrocoagulation allows the removal of mucosa from the ossicles in an easy, fast and safe manner, enabling the use of bone cement for ossicular chain reconstruction.

Copyright

Corresponding author

Address for correspondence: Dr Camille Galy-Bernadoy, ENT – Head and Neck Surgery Department, Gui de Chauliac University Hospital, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France Fax: +33 4 67 33 67 28 E-mail: galycamille@gmail.com

References

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1 Babu, S, Seidman, MD. Ossicular reconstruction using bone cement. Otol Neurotol 2004;25:98101
2 Galy-Bernadoy, C, Akkari, M, Mathiolon, C, Mondain, M, Uziel, A, Venail, F. Comparison of early hearing outcomes of type 2 ossiculoplasty using hydroxyapatite bone cement versus other materials. Eur Ann Otorhinolaryngol Head Neck Dis 2014;131:289–92
3 Wegner, I, van den Berg, JW, Smit, AL, Grolman, W. Systematic review of the use of bone cement in ossicular chain reconstruction and revision stapes surgery. Laryngoscope 2015;125:227–33
4 Van Rompaey, V, Claes, G, Somers, T, Offeciers E. Erosion of the long process of the incus in revision stapes surgery: malleovestibular prosthesis or incus reconstruction with hydroxyapatite bone cement? Otol Neurotol 2011;32:914–18
5 Hamilton, JW. Systematic preservation of the ossicular chain in cholesteatoma surgery using a fiber-guided laser. Otol Neurotol 2010;31:1104–8
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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