Micro macroporous biphasic ceramics and fibrin sealant as a moldable material for bone reconstruction in chronic otitis media surgery. A 15 years experience

  • M. Bagot d'Arc
  • G. Daculsi


Bone reconstruction is still a matter of concern in middle ear surgery despite the large number of surgical techniques proposed. Combination of biphasic calcium phosphate bioceramics with human fibrin sealant forms a moldable material easy to apply for bone reconstruction. Since 1986, we have been using this composite for reconstruction of mastoid cavities during chronic otitis media surgery. Granules of ceramic provide immediate mechanical stability and later on, promote osseoinduction when fibrin sealant forms a strong bond between granules enhancing the wound healing process. After checking feasibility, efficacy and tolerance through a controled study on dogs by filling mastoid cavities, we started a clinical series comprising yet 66 mastoid reconstructions. A retrospective data analysis on 63 patients with an average follow up of 42 months including 12 histological controls confirms the stability of bone reconstruction with a remarkable tolerance of the skin in contact. Biopsies confirmed progressive replacement of material by lamellar newly formed bone. Mastoid cavities have a randomed shape making complex bone reconstruction procedure and their filling by the composite constitutes an easy way and represents a highly satisfactory procedure. The authors considered that this should be explored in other indications of bone surgery.


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  1. 1.
    M. Portmann, “Traité de technique chirurgicale ORL et cervico-faciale” (Masson, Paris, 1986) p. 223.Google Scholar
  2. 2.
    T. Palva, Arch. Otolaryngol. Head Neck Surg. 77 (1963) 570.Google Scholar
  3. 3.
    M. Tos, Clin. Otolaryngol. 3 (1978) 255.Google Scholar
  4. 4.
    R. Perkins, Laryngoscope 86 (1976) 416.Google Scholar
  5. 5.
    M. Gersdorff, D. Franceschi, M. Bagot D'Arc, A. Dhem and G. Daculsi, in “Transplants and Implants in Otology”, edited by G. Babighian and H. Feldmann (Kugler Pub., Amsterdam, 1988) p. 69.Google Scholar
  6. 6.
    H. L. Wullstein, S. R. Wullstein, K. Köster and H. Heide, in “Plastic and Reconstructive Surgery of the Head and Neck”, The International Symposium, Rehabilitative Surgery 2 (Verlag Grune & Stratton, New York, 1981) p. 354.Google Scholar
  7. 7.
    D. S. Metseger, T. D. Driskell and J. R. Paulstrud, J. Am. Dent. 105 (1982) 1035.Google Scholar
  8. 8.
    M. Jarcho, Clin. Orthop. 157 (1981) 259.Google Scholar
  9. 9.
    J. F. Osborn, J. Bioeng. 1 (1980) 108.Google Scholar
  10. 10.
    C. P. Klein, A. A. Driessen, K. De Groot and A. Van Der Hoof, J. Biomed. Mater. 17 (1983) 769.Google Scholar
  11. 11.
    O. Gauthier, J.-M. Bouler, E. Aguado, P. Pilet and G. Daculsi, Biomaterials 19(1–3) (1998) 133.Google Scholar
  12. 12.
    G. Daculsi, N. Passuti, S. Martin, C. Deudon, R. Z. Legeros and S. Raher, J. Biomed. Mater. Res. 24 (1990) 379.Google Scholar
  13. 13.
    E. Nery, R. Z. Legeros and K. L. Lynch, J. Periodontol. 63 (1992) 729.Google Scholar
  14. 14.
    R. Z. Legeros and G. Daculsi, in “Handbook of Bioactive Ceramics”, edited by T. Yamamuro et al. (CRC Press, 1991).Google Scholar
  15. 15.
    R. Z. Legeros, Adv. Dent. Res. 2 (1988) 164.Google Scholar
  16. 16.
    N. Passuti, G. Daculsi, J. M. Rogez, S. Martin and J. V. Bainvel, Clin. Orthop. Relat. Res. 67 (1990) 234.Google Scholar
  17. 17.
    B. Zederfeldt, in “Fibrin Sealing in Surgical and Nonsurgical Fields: Wound Healing -Vol. 1”, edited by G. Schlag and H. Redl (Springer-Verlag Berlin-Heidelberg, 1994) p. 18.Google Scholar
  18. 18.
    M.-F. Harmand, D. Michel and M. Bagot D'Arc, in “Fibrin Sealing in Surgical and non-Surgical Fields”, edited by G. Schlag (Springer Pub., Heidelberg, 1994) p. 52.Google Scholar
  19. 19.
    G. Schlag, H. Redl, M. Turnher and H. P. Dinges, in “Fibrin sealant in operative medicine”, Vol 1. edited by G. Schlag and H. Redl (Springer, Berlin Heidelberg New York, 1986) p. 3.Google Scholar
  20. 20.
    M. Bagot D'Arc, P. Corlieu and G. Daculsi, in “Transplants and Implants in Otology”, edited by N. Yanagihara and J. Suzuki (Kugler, Amsterdam, 1992) p. 145.Google Scholar
  21. 21.
    M. Bagot D'Arc and G. Daculsi, in “Proceedings of the XXth European Congress of ENT”, edited by Monduzzi (Berlin, 2000).Google Scholar
  22. 22.
    G. Daculsi, M. Bagot D'Arc, P. Corlieu and M. Gersdorff, Ann. Otol. Rhinol. Laryngol. 101(8) (1992) 669.Google Scholar
  23. 23.
    P. J. Corlieu and M. Bagot D'Arc, Transpl. Impl. Otol. II 1(5) (1992) 147.Google Scholar
  24. 24.
    A. W. Blayney, J. P. Erre, A. Dhem and Y. Cazals, Interfaces Med. Mech. 13 (1987) 34.Google Scholar

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© Kluwer Academic Publishers 2003

Authors and Affiliations

  • M. Bagot d'Arc
    • 1
  • G. Daculsi
    • 2
  1. 1.Bachaumont HospitalParisFrance
  2. 2.INSERM EM 99 03 Materials of biological interestNantesFrance

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