Hydroxyapatite cement cranioplasty in translabyrinthine acoustic neuroma surgery.
OBJECTIVE
Hydroxyapatite cement cranioplasty (HAC) after translabyrinthine resection of acoustic neuroma is a promising new technique for wound reconstruction. This study reviews the efficacy of HAC for the prevention of cerebrospinal fluid (CSF) leakage and the long-term wound outcomes of HAC versus abdominal fat graft (AFG) reconstruction.


METHODS
This retrospective study of l08 consecutive acoustic neuromas operated on by Pittsburgh Ear Associates uses chart review, telephone interview, and mail questionnaire data. Fifty-four patients received AFG dural repair, and 54 patients received HAC.


RESULTS
Seven AFG patients (12.5%) had CSF leaks versus 2 (3.7%) of the overall group of 54 HAC patients. However, none (0%) of the 47 HAC patients had CSF leakage with current HAC techniques. HAC also produced significantly less postauricular wound depression and superior cosmetic results in comparison with AFG. Although HAC patients experienced less postoperative discomfort, wound complications requiring medical or surgical intervention were extremely uncommon in both groups.


CONCLUSIONS
HAC offers significant CSF leakage control and long-term cosmetic and comfort advantages over AFG alone. We recommend HAC as the standard closure technique for translabyrinthine acoustic neuroma surgery.
Arriaga
Moisês A
MA
Pittsburgh Ear Associates, Allegheny General Hospital Hearing and Balance Center, PA 15212, USA.
Chen
Douglas A
DA
D000005:Abdomen / Q000503:physiopathology / Q000601:surgery*; D000273:Adipose Tissue / Q000503:physiopathology / Q000637:transplantation*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001843:Bone Cements / Q000627:therapeutic use*; D017886:Durapatite / Q000627:therapeutic use*; D007758:Ear, Inner / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009464:Neuroma, Acoustic / Q000503:physiopathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012886:Skull / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery*; D013353:Subdural Effusion / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology
D001672:Biocompatible Materials; D001843:Bone Cements; D017886:Durapatite