Ionomeric cement in the human middle ear cavity: long-term results of 23 cases.
OBJECTIVE
The long-term results of the implantation of glass ionomer cement in the human mastoid and middle ear were studied.


METHODS
A prospective study of the survival of bone cement in the middle ear.


METHODS
Ionocem (IONOS, Medizinische Produkte Gmbh & Co., Seefeld/Obb, Germany), a two-compound bone material that forms a stable, water-proof junction with bone, was implanted in 23 middle ears of 23 patients (13 male and 10 female patients). Closure of the dehiscence of the tegmen was performed in 7 cases, obliteration of the mastoid cavity in 10 cases, and ossicular chain reconstruction in 6 cases.


RESULTS
The follow-up period was 5.1 years. Complications attributable to operation were not seen, but adverse tissue reaction with severe middle ear infection and abundant otorrhea occurred in six cases after 12 months, requiring repeat operation. In three more cases, a spontaneous extrusion of the bone cement was seen after 4 years. The bone cement was totally extruded in nine cases. The mean survival time was 28 months.


CONCLUSIONS
The use of Ionocem for obliteration of the mastoid cavity or for the closure of dehiscence of the tegmen has a high risk of extrusion. Therefore, it is not the first-choice material to use for obliteration or tegmen defect closure in the middle ear.
Kupperman
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Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, The Netherlands.
Tange
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D000293:Adolescent; D000328:Adult; D000538:Aluminum Silicates / Q000009:adverse effects; D001672:Biocompatible Materials / Q000009:adverse effects; D001843:Bone Cements / Q000009:adverse effects; D002648:Child; D004427:Ear Diseases / Q000209:etiology / Q000601:surgery*; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000209:etiology / Q000601:surgery; D005899:Glass Ionomer Cements; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation
D000538:Aluminum Silicates; D001672:Biocompatible Materials; D001843:Bone Cements; D005899:Glass Ionomer Cements; C088058:polymaleinate ionomer