{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:11:05Z","timestamp":1760958665811,"version":"build-2065373602"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":71,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the possibility of hydroxyapatite as a safe and effective alternative to currently used bioavailable materials for repair of tegmen defects and labyrinthine fistulas in the setting of cholesteatoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary\u2010level\u2010care hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic medical records of patients 18+ years undergoing cholesteatoma\u2010removal surgery between 2013 and 2022 were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two patients diagnosed with cholesteatoma who underwent repair of either a tegmen defect or labyrinthine fistula using hydroxyapatite were evaluated. There were 17 canal wall up (CWU) and 5 canal wall down (CWD) surgeries. The cholesteatoma recidivism rate was 18.2% (n\u2009=\u20094) and the recurrence rate was 4.5% (n\u2009=\u20091). To ensure that these rates were similar to cholesteatoma\u2010removal surgeries in which hydroxyapatite was not used, a 22 age, gender, and operative technique\u2010matched cohort was evaluated. For patients with CWU surgeries, the rate of recurrence and recidivism were identical between both cohorts (0% and 23.5%, respectively; <jats:italic>P<\/jats:italic>\u2009=\u20091 for both). While in CWD surgeries, there was a nonstatistically significant difference in the recurrence as there was only 1 patient with recurrence in the hydroxyapatite group (<jats:italic>P<\/jats:italic>\u2009=\u20091). Three (13.5%) patients in the hydroxyapatite group had a local infection and 1 (4.5%) had a subacute mastoid infection. All patients with semicircular canal fistulas had consistent bone lines on postoperative audiograms, with no worsening sensorineural hearing loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our cohort, hydroxyapatite was safe and successful in repairing skull base defects and inner\u2010ear fistulas in the setting of cholesteatoma with a low rate of postoperative infection and no evidence of a higher rate of cholesteatoma recurrence. Further studies are needed to assess population generalizability.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oto2.151","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T14:48:46Z","timestamp":1718117326000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Safety and Efficacy of Hydroxyapatite Repair of Cholesteatoma Skull Base Defects"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2740-7516","authenticated-orcid":false,"given":"Rema","family":"Shah","sequence":"first","affiliation":[{"name":"Yale University School of Medicine New Haven Connecticut USA"},{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4544-9357","authenticated-orcid":false,"given":"Nofrat","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-67799-5"},{"volume-title":"Middle Ear Cholesteatoma","year":"2022","author":"Kennedy 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