Objective: To explore the effect of hydroxyapatite (HA) combined with concentrated growth factor (CGF) on the cavity filling during endoscopic mastoidectomy in patients with middle ear cholesteatoma. Methods: The data of patients with middle ear cholesteatoma who underwent endoscopic canal wall down (CWD) mastoidectomy and mastoid obliteration with hydroxyapatite in Huazhong University of Science and Technology Union Shenzhen Hospital from December 2017 to October 2023 were retrospectively analyzed. The patients were divided into observational group (HA+CGF) and control group (HA) according to whether CGF was used. The postoperative follow-up time was not less than 6 months.The otoendoscopy results of the two groups were collected, and the excretion incidence of hydroxyapatite bone powder exposure was observed. The degree of epithelialization of the mastoid cavity and the time required for complete epithelialization were compared between the two groups using a subjective epithelialization scoring scale at one month post-operation. Results: A total of 58 patients (36 males and 22 females) aged (39.4±13.4) years were collected, including 26 left ears and 32 right ears. There were 30 cases in HA group and 28 cases in HA+CGF group, respectively. No statistically differences in gender, location and age were detected between the two groups (all P>0.05). The excretion incidence of bone powder exposure was 3.4% (2/58), with 1 case in HA group and 1 case in HA+CGF group, respectively. The median (Q1, Q3) subjective epithelialization score at one month post-operation was 1 (1, 2) in the HA+CGF group and 2(1, 2) in the HA group, with no statistically significant difference between the two groups (P=0.032). The results of 60-day follow-up after otoendoscopy showed that the proportion of complete epithelialization was 74.1% (20/27) in HA+CGF group and 48.3% (14/29) in HA group, and there was a statistically significant difference between the two groups (P=0.048). Conclusion: HA combined with CGF has a better effect on the cavity filling during endoscopic mastoidectomy in patients with middle ear cholesteatoma.
目的： 探讨羟基磷灰石（HA）联合自体血浓缩生长因子（CGF）用于耳内镜下中耳胆脂瘤术中乳突填塞的效果。 方法： 回顾性分析2017年12月至2023年10月于华中科技大学协和深圳医院行耳内镜下外耳道入路开放式乳突根治术（CWD）并使用HA骨粉填塞乳突的中耳胆脂瘤患者资料，根据是否应用CGF分为HA组和HA+CGF组。术后定期随访且时间≥6个月，观察HA骨粉外露排出发生情况，并采用上皮化主观评分量表评估两组患者术后1个月乳突腔上皮化程度，比较两组HA骨粉外露排出发生率、乳突腔上皮化程度及完全上皮化所需时间。 结果： 共纳入58例患者，男36例，女22例，年龄（39.4±13.4）岁；左侧耳26例，右侧耳32例；其中HA组30例，HA+CGF组28例。HA组与HA+CGF组性别、耳侧别、年龄差异均无统计学意义（均P>0.05）；术后随访期间骨粉外露排出发生率3.4%（2/58），HA组与HA+CGF组各1例；HA+CGF组术后1个月耳内镜下上皮化主观评分［M（Q1，Q3）］小于HA组［1（1，2）分比2（1，2）分，P=0.032］；HA+CGF组60 d内完全上皮化比例高于HA组［74.1%（20/27）比48.3%（14/29），P=0.048］。 结论： HA联合CGF用于耳内镜下中耳胆脂瘤术中乳突填塞效果良好。.