Mid-term outcomes of mastoid obliteration with biological hydroxyapatite versus bioglass: a radiological and clinical study

An Effect of Cyclosporin A in a Treatment of Temporal Bone Defect Using hBM-MSCs

Background. The treatment of middle ear cholesteatoma requires surgical treatment and the reconstruction of the temporal bone, which represents an ongoing problem. Otologists have focused on the research of materials allowing an airy middle ear and the preservation of hearing function to reconstruct the temporal bone. Methods. This study evaluated the effect of cyclosporin A (CsA) and a combined biomaterial in the healing process of postoperative temporal bone defects in an animal model. Cultured human Bone Marrow Mesenchymal Stromal Cells (hBM-MSCs) were mixed with hydroxyapatite (Cem-Ostetic^®), and subsequently applied as a bone substitute after middle ear surgery, showing that the therapeutic potential of hBM-MSCs associated with bone regeneration and replacement is directly influenced by CsA, confirming that it promotes the survival of MSCs in vivo. Results. The therapeutic efficacy of the combination of MSCs with CsA is greater than the sole application of MSCs in a hydroxyapatite carrier. Conclusion. The reconstruction of a temporal bone defect using hBM-MSCs requires an immunosuppressant to improve the results of treatment.

Can phosphatidylcholine increase the efficacy of bioactive glass graft when used as a carrier? an experimental study

Aim: Bioactive glass (Bioglass) is a substance causing strong mechanical bondings at the interface of soft tissue-biomaterial-bone through a series of biochemical and biophysical reactions, commonly used to restore developing bone defects due to surgery. On the other hand, phosphatidylcholine is a lipid substance increasing antibiotics’ efficiency as a carrier. Since we met no study using the combination of Bioglass and phosphatidylcholine for bone defects, we aimed to investigate whether the bioglass-phosphatidylcholine combination would be more effective. Material and Method: Thirty Sprague-Dawley 3-6-months-old female rats with a mean weight of 400 gr were divided into five subgroups (six in each group). A 5-mm critical defect was created in the middle of the condyle throughout the burr’s diameter bilaterally. The phosphatidylcholine-bioglass graft was placed at one side, and Bioglass contralaterally to fill the defect. The rats were sacrificed at 24 hours, 72 hours, first, third, and sixth weeks postoperatively. The right and left rat femurs were removed and examined histopathologically. Results: There was no statistically significant difference between the groups regarding filling volume, newly formed and necrotic bone, fibrous tissue, residual graft material, integration, foreign body reaction, and defect organization, indicating that Bioglass served efficiently for filling the defect. In addition, phosphatidylcholine neither augmented nor impaired the healing process. Conclusion: These results indicated that Bioglass served efficiently for filling the defect, and the presence of phosphatidylcholine neither augmented nor impaired the healing process. However, further experimental studies are required until its clinical application is implemented.