Mechanical treatment and autoclaving of middle ear ossicles from cholesteatomatous ears

Aim of the study: The authors present a prospective histomorphological study of middle ear ossicles, harvested from cholesteatomous ears, to evaluate for presence of residual cholesteatoma after mechanical treatment and short-time autoclaving. Materials and methods: Sixty ossicles were used as specimens in this study. The ossicles were grouped as follows: Group A - ossicles stripped and burred using a fine diamond burr under microscopic control. Group B - ossicles autoclaved for 4 min at 134°C after mechanical burring under microscopic control. Results: In group A, 30 ossicles were histologicaly examined after mechanical treatment. The residual disease was found in one badly eroded ossicle. In group B, 30 ossicles were histologicaly examined after mechanical treatment and autoclaving. That treatment eliminated cholesteatoma in all cases. The difference of results in these two treatment methods was not statistically significant. Conclusion: Authors recommend using mechanical cleaning in cases of mildly eroded ossicles. In cases of badly eroded ossicles authors recommend to either apply a combination of mechanical and autoclaving treatment. The study proved that 4 minutes of autoclaving at 134°C after mechanical cleaning provides safe bone autografts.