A Comparison of the Sticky Bone Obliteration Technique and Obliteration Using S53P4 Bioactive Glass After Canal Wall Down Ear Surgery: A Preliminary Study

<b>Background:</b> The aim of this study was to analyse the results of the mastoid obliteration technique with sticky bone (SB) and compare them with those obtained using bioactive glass S53P4 (BAG). <b>Methods:</b> This prospective preliminary study comprised 28 adults who underwent canal wall down (CWD) surgery using two mastoid obliterative techniques: SB (<i>n</i> = 21) or BAG (<i>n</i> = 7). The SB group was treated with the patients' own bone dust and injectable platelet rich fibrin (IPRF) (<i>n</i> = 13%) or bone dust, IPRF, and additionally allogenic lyophilised demineralised bone (<i>n</i> = 9%). <b>Results:</b> Nine months after the surgery, in the SB group, retroauricular depression was observed in three (14%) patients, temporary retroauricular fistula in one (5%), and a conical and smooth external auditory canal (EAC) was achieved in 15 (71%). Mean EAC capacity was 0.6 mL higher than in the contralateral ear. In the SB group, the tympanic membrane (TM) of nineteen (91%) patients was fully healed, one (5%) had TM perforation, and one (5%) developed a retraction pocket. In the BAG group, retroauricular depression was observed in four (57%) patients, temporary retroauricular fistula was present in one (14%), and a conical and smooth EAC was achieved in five (71%). Mean EAC capacity was 0.3 mL higher than on the opposite side. In the BAG group, we stated six (86%) patients with fully healed TM and one (14%) with a retraction pocket. One cholesteatoma was found in the BAG group and two in SB, (14% vs. 10%). After 9 months, all patients in both groups achieved a dry and self-cleaning cavity. <b>Conclusions:</b> Mastoid obliteration in CWD surgery using SB or BAG allows for reconstruction of the conical shape of the EAC with a volume similar to that of a healthy ear. Both techniques seem to have a minimal risk of complications and result in a dry, self-cleaning cavity. Further studies concerning a larger series of cases are necessary to confirm the findings of this preliminary analysis.