Learning Objectives: Bioactive glass granules can be used as an alternative filler material for obliteration after subtotal petrosectomy.

Introduction: Subtotal petrosectomy for chronic suppurative otitis media requires obliteration of the mastoid cavity and middle ear space. Generally, abdominal fat is used for this purpose. A considerable risk of using fat is infection, which might require revision surgery. The use of bioactive glass granules seems an attractive alternative since the granules have antibacterial properties.

Methods: A 59 year old male patient with a history of chronic suppurative otitis media of the right ear, complicated by a sudden profound perceptive hearing loss was already treated with a mastoidectomy 6 years ago and thereafter extensively treated conservatively. Because of recurrent chronic otorrhoea and pain we decided to perform a subtotal petrosectomy with blind sac closure of the external ear canal , closure of the Eustachian tube, and obliteration of the cavity with S53P4 bioactive glass granules (BonAlive Biomaterials Ltd., Turku, Finland). A wound drain was kept in place for 7 days.

Results: No complications occured peri-operatively and a dry ear was obtained with complete relief of pain. Duration of follow-up is now 6 months and no late adverse events were observed.

Conclusions: S53P4 bioactive glass granules are feasible to use for obliteration after subtotal petrosectomy. Elimination of chronic suppurative otitis media can be achieved with this technique. Bioactive granules might be an alternative for abdominal fat, which has a risk of infection.