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Improvement of eustachian tube function by tissue‐engineered regeneration of mastoid air cells
Author(s) -
Kanemaru Shinichi,
Umeda Hiroo,
Yamashita Masaru,
Hiraumi Harukazu,
Hirano Shigeru,
Nakamura Tatsuo,
Ito Juichi
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.23626
Subject(s) - tympanoplasty , eustachian tube , medicine , cholesteatoma , middle ear , regeneration (biology) , surgery , decompression , biology , microbiology and biotechnology
Objectives/Hypothesis: Most cases of chronic otitis media (OMC) are associated with poor development of the mastoid air cells (MACs) and poor Eustachian tube (ET) function. We have previously reported that MAC regeneration can effectively eliminate intractable OMC. In this study, we assessed the ability of regenerated MACs to restore normal gas exchange function and contribute to improved ET function. Study Design: Clinical trial with control. Setting: General hospitals. Materials and Methods: Seventy‐six patients with OMC, including cholesteatoma and adhesive otitis media, received tympanoplasty and MAC regeneration therapy. At the first‐stage of tympanoplasty, artificial pneumatic bones and/or autologous bone fragments were implanted into the opened mastoid cavity. At the 2nd‐stage operation, a nitrous oxide (N2O) gas study was performed in 10 patients to measure middle ear pressure (MEP). For the control group, MEP was measured in five patients with good MAC development during cochlear implantation or facial nerve decompression. ET function was measured twice in each patient, once before the 1st operation and 6 months after the second operation. Results: At the 2nd‐stage operation, in all cases with regenerated MACs and in the normal control group, MEP changed after administration of N2O. In contrast, no change in MEP was observed in cases with unregenerated MACs. In 70% (n = 37/53) of the regenerated MAC group, ET function was improved, whereas improvement of ET function was observed in only 13% (n = 3/23) of the unregenerated MAC group. Conclusions: Tissue‐engineered regeneration of MACs improves ET function and gas exchange in the middle ear. Laryngoscope, 2012