title: Lateral Attic Wall Reconstruction with Glass Ionomer Bone Cement in the Management of Primary Acquired Attic Cholesteatoma in Children: A Preliminary Experience.
abstract: OBJECTIVE
  To assess the effectiveness of glass ionomer bone cement (GIBC) in lateral attic wall reconstruction after primary acquired attic cholesteatoma surgery.
  
  
  METHODS
  This prospective study was conducted on twenty children collected from the ENT outpatient clinics of a secondary and tertiary hospital. All patients presented with chronic suppurative otitis media with cholesteatoma of the primary acquired attic type. All patients underwent intact canal wall mastoidectomy (ICWM) with a transcanal atticotomy to address primary cholesteatoma involving the attic and the supratubal recess. Removal of the incus with or without decapitation of the malleus depended on the extension of the pathology. GIBC was used to build up the lateral attic wall in all cases. Ossiculoplasty and tympanoplasty were performed according to the extent of disease.
  
  
  RESULTS
  All patients had integrated skin covering the reconstructed attic wall with no signs of granulation tissue formation, canal wall edema, glass ionomer extrusion, or foreign body reaction on the 6th month, 1st year and 2nd year follow-up visits. Also, no persistent otorrhea was noted. The postoperative air-bone gap was significantly improved (p=0.007).
  
  
  CONCLUSIONS
  GIBC could be considered as a reliable artificial material for reconstruction of the lateral attic wall after transmeatal atticotomy in ICWM, making it feasible to avoid cavity problems of canal wall down mastoidectomy, especially in children.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Alexandria School of Medicine, University of Alexandria, Alexandria, Egypt. ahmomran95@yahoo.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Omran
authors.forename: Fatthi Abdel
authors.initials: FA
authors.lastname: Baki
authors.forename: Ahmed
authors.initials: A
authors.lastname: Amin
mesh_terms: D000180:Acrylic Resins / Q000627:therapeutic use*; D000293:Adolescent; D001843:Bone Cements / Q000627:therapeutic use*; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012822:Silicon Dioxide / Q000627:therapeutic use*; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*
chemical_list: D000180:Acrylic Resins; D001843:Bone Cements; C015897:glass ionomer; D012822:Silicon Dioxide