Use of Biodesign® Otologic Graft in Canal Wall Down Mastoidectomy: A Prospective, Randomized Trial

NCT ID: NCT03902938

Last Updated: 2025-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE4

Study Classification

INTERVENTIONAL

Study Start Date

2018-10-02

Study Completion Date

2022-07-01

Brief Summary

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This is a prospective, randomized trial to evaluate canal wall down mastoidectomy (CWDM) healing outcomes using Biodesign® small intestine submucosa graft compared to autologous temporalis fascia graft.

Detailed Description

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Patients 18 or older will undergo primary canal wall down mastoidectomy. Patients with known biologic sensitivity or cultural objection to use of porcine materials will be excluded.

Data will be derived from the medical record and surgeon reports as detailed on pre-op and follow-up forms. Variables collected include age, gender, medical co-morbidities, body mass index, pre-operative audiometric values (including word recognition score, pure tone average, and air bone gap), side of surgery, size of operative cavity, infectious state (draining versus dry), exact surgical procedure, presence of cholesteatoma, time to dry cavity, time to complete epithelialization (as observed directly by the surgeon), and post-operative complications (such as persistent perforation, drainage, granulation tissue formation, and facial nerve outcomes). Dates and patient number will be recorded. Patients will be randomly assigned using randomization software, whereby patients will be assigned a sequential research number that is pre-randomized to one research arm. The study cannot be blinded, as the surgeon will be able to identify which graft will be used. De-identified photographs of the post-operative outcomes at each time point will be recorded photographically. Three physicians will review these photographs without prior knowledge of the treatment arm.

Conditions

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Otologic Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Biodesign Otologic Graft

Graft following canal wall down mastoidectomy.

Group Type EXPERIMENTAL

Biodesign Otologic graft

Intervention Type BIOLOGICAL

Patient's mastoid cavity will be covered with porcine small intestine submucosa, Biodesign.

Autograft temporalis fascia

Graft following canal wall down mastoidectomy.

Group Type ACTIVE_COMPARATOR

Autograft temporalis fascia

Intervention Type OTHER

Patient's mastoid cavity will be covered with covered with autograft.

Interventions

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Biodesign Otologic graft

Patient's mastoid cavity will be covered with porcine small intestine submucosa, Biodesign.

Intervention Type BIOLOGICAL

Autograft temporalis fascia

Patient's mastoid cavity will be covered with covered with autograft.

Intervention Type OTHER

Other Intervention Names

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Porcine small intestine submucosa

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing primary canal wall mastoidectomy

Exclusion Criteria

* Patients with a known biologic sensitivity or a cultural aversion to the use of porcine materials.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Henry Ford Health System

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Seilesh Babu, MD

Role: PRINCIPAL_INVESTIGATOR

Physician of record

Locations

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Ascension Providence Hospital, Novi Campus

Novi, Michigan, United States

Site Status

Countries

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United States

References

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Illing E, Chaaban MR, Riley KO, Woodworth BA. Porcine small intestine submucosal graft for endoscopic skull base reconstruction. Int Forum Allergy Rhinol. 2013 Nov;3(11):928-32. doi: 10.1002/alr.21206. Epub 2013 Aug 16.

Reference Type BACKGROUND
PMID: 23956139 (View on PubMed)

Gantz BJ, Wilkinson EP, Hansen MR. Canal wall reconstruction tympanomastoidectomy with mastoid obliteration. Laryngoscope. 2005 Oct;115(10):1734-40. doi: 10.1097/01.MLG.0000187572.99335.cc.

Reference Type BACKGROUND
PMID: 16222186 (View on PubMed)

Ambro BT, Zimmerman J, Rosenthal M, Pribitkin EA. Nasal septal perforation repair with porcine small intestinal submucosa. Arch Facial Plast Surg. 2003 Nov-Dec;5(6):528-9. doi: 10.1001/archfaci.5.6.528.

Reference Type BACKGROUND
PMID: 14623693 (View on PubMed)

Ansaloni L, Cambrini P, Catena F, Di Saverio S, Gagliardi S, Gazzotti F, Hodde JP, Metzger DW, D'Alessandro L, Pinna AD. Immune response to small intestinal submucosa (surgisis) implant in humans: preliminary observations. J Invest Surg. 2007 Jul-Aug;20(4):237-41. doi: 10.1080/08941930701481296.

Reference Type BACKGROUND
PMID: 17710604 (View on PubMed)

Bejjani GK, Zabramski J; Durasis Study Group. Safety and efficacy of the porcine small intestinal submucosa dural substitute: results of a prospective multicenter study and literature review. J Neurosurg. 2007 Jun;106(6):1028-33. doi: 10.3171/jns.2007.106.6.1028.

Reference Type BACKGROUND
PMID: 17564175 (View on PubMed)

Chhapola S, Matta I. Mastoid obliteration versus open cavity: a comparative study. Indian J Otolaryngol Head Neck Surg. 2014 Jan;66(Suppl 1):207-13. doi: 10.1007/s12070-011-0429-x. Epub 2012 Jan 1.

Reference Type BACKGROUND
PMID: 24533385 (View on PubMed)

Kanazawa Y, Shojaku H, Okabe M, Fujisaka M, Takakura H, Tachino H, Tsubota M, Watanabe Y, Nikaido T. Application of hyperdry amniotic membrane patches without fibrin glue over the bony surface of mastoid cavities in canal wall down tympanoplasty. Acta Otolaryngol. 2012 Dec;132(12):1282-7. doi: 10.3109/00016489.2012.701329. Epub 2012 Nov 6.

Reference Type BACKGROUND
PMID: 23126613 (View on PubMed)

Knoll LD. Use of porcine small intestinal submucosal graft in the surgical management of Peyronie's disease. Urology. 2001 Apr;57(4):753-7. doi: 10.1016/s0090-4295(00)01079-7.

Reference Type BACKGROUND
PMID: 11306396 (View on PubMed)

Kobayashi T, Gyo K, Komori M, Hyodo M. Polyglycolic acid sheet attached with fibrin glue can facilitate faster epithelialization of the mastoid cavity after canal wall-down tympanoplasty. Auris Nasus Larynx. 2017 Dec;44(6):685-689. doi: 10.1016/j.anl.2017.01.013. Epub 2017 Feb 20.

Reference Type BACKGROUND
PMID: 28215637 (View on PubMed)

Lin HK, Godiwalla SY, Palmer B, Frimberger D, Yang Q, Madihally SV, Fung KM, Kropp BP. Understanding roles of porcine small intestinal submucosa in urinary bladder regeneration: identification of variable regenerative characteristics of small intestinal submucosa. Tissue Eng Part B Rev. 2014 Feb;20(1):73-83. doi: 10.1089/ten.TEB.2013.0126. Epub 2013 Jul 25.

Reference Type BACKGROUND
PMID: 23777420 (View on PubMed)

Martini A, Morra B, Aimoni C, Radice M. Use of a hyaluronan-based biomembrane in the treatment of chronic cholesteatomatous otitis media. Am J Otol. 2000 Jul;21(4):468-73.

Reference Type BACKGROUND
PMID: 10912689 (View on PubMed)

Murphy F, Corbally MT. The novel use of small intestinal submucosal matrix for chest wall reconstruction following Ewing's tumour resection. Pediatr Surg Int. 2007 Apr;23(4):353-6. doi: 10.1007/s00383-007-1882-1. Epub 2007 Feb 8.

Reference Type BACKGROUND
PMID: 17287942 (View on PubMed)

Ort SA, Ehrlich HP, Isaacson JE. Acellular porcine intestinal submucosa as fascial graft in an animal model: applications for revision tympanoplasty. Otolaryngol Head Neck Surg. 2010 Sep;143(3):435-40. doi: 10.1016/j.otohns.2010.04.268.

Reference Type BACKGROUND
PMID: 20723784 (View on PubMed)

Palva T. Surgical treatment of chronic middle ear disease. II. Canal wall up and canal wall down procedures. Acta Otolaryngol. 1987 Nov-Dec;104(5-6):487-94. doi: 10.3109/00016488709128279.

Reference Type BACKGROUND
PMID: 3434271 (View on PubMed)

Rutner AB, Levine SR, Schmaelzle JF. Processed porcine small intestine submucosa as a graft material for pubovaginal slings: durability and results. Urology. 2003 Nov;62(5):805-9. doi: 10.1016/s0090-4295(03)00664-2.

Reference Type BACKGROUND
PMID: 14624898 (View on PubMed)

Seymour PE, Leventhal DD, Pribitkin EA. Lip augmentation with porcine small intestinal submucosa. Arch Facial Plast Surg. 2008 Jan-Feb;10(1):30-3. doi: 10.1001/archfacial.2007.17.

Reference Type BACKGROUND
PMID: 18209120 (View on PubMed)

Sheehy JL. Cholesteatoma surgery: canal wall down procedures. Ann Otol Rhinol Laryngol. 1988 Jan-Feb;97(1):30-5. doi: 10.1177/000348948809700106.

Reference Type BACKGROUND
PMID: 3277524 (View on PubMed)

Spiegel JH, Kessler JL. Tympanic membrane perforation repair with acellular porcine submucosa. Otol Neurotol. 2005 Jul;26(4):563-6. doi: 10.1097/01.mao.0000169636.63440.4e.

Reference Type BACKGROUND
PMID: 16015147 (View on PubMed)

Wetmore SJ, Bueller HA, Cost JL. Split thickness skin grafting in canal wall down tympanomastoidectomy. Otol Neurotol. 2014 Jan;35(1):97-100. doi: 10.1097/MAO.0b013e3182a4445d.

Reference Type BACKGROUND
PMID: 24136321 (View on PubMed)

Other Identifiers

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1322212

Identifier Type: -

Identifier Source: org_study_id