Indications for hydroxyapatite cement reconstruction in lateral skull base surgery.
Preliminary data on the use of hydroxyapatite cement to restore cranial bone integrity has shown excellent results. Cranial base reconstruction has been accomplished for translabyrinthine, middle cranial fossa, and suboccipital craniectomy defects, as well as extensive temporal bone fractures. Fifteen patients have been followed for up to 2 years with no evidence of complication from use of the hydroxyapatite cement. Exposure to cerebrospinal fluid does not appear to alter its stability, and pre-existing infection appears to be the only contraindication to its use. Stability of the cement has been confirmed by serial radiographic analyses. This paper reviews the chemical structure and bioactivity of hydroxyapatite cement and employs case studies to illustrate the applications of this new biomaterial in lateral skull base surgery.
Kveton
J F
JF
Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut 06520-8041, USA.
Friedman
C D
CD
Costantino
P D
PD
D000328:Adult; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology / Q000601:surgery; D003399:Craniotomy / Q000379:methods; D017886:Durapatite / Q000494:pharmacology / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*; D012887:Skull Fractures / Q000601:surgery*; D013701:Temporal Bone / Q000293:injuries / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D017886:Durapatite