title: Delayed extrusion of hydroxyapatite after transpetrosal reconstruction.
abstract: OBJECTIVE
  : To review the long-term results of hydroxyapatite closure of transpetrosal defects.
  
  
  METHODS
  : Retrospective chart review.
  
  
  METHODS
  : One hundred seventy-seven patients were followed for more than 5 years. After surgical management by way of transpetrosal routes, hydroxyapatite was placed after medial wound closure with abdominal fat and before a three-layered lateral soft tissue closure.
  
  
  RESULTS
  : Among this group of patients, three (1.7%) cerebrospinal fluid (CSF) leaks were encountered. None of these required re-operation. Delayed extrusion of hydroxyapatite with concomitant superficial wound infections have occurred in seven (4%) patients. All required operative re-intervention.
  
  
  CONCLUSIONS
  : Hydroxyapatite has proven to be an effective material in the closure of skull base defects. Nevertheless, delayed extrusion of this agent can occur, resulting in the potential for morbidity and the need for operative re-intervention.
authors.affiliation: The Neurosciences Institute (TNI), Department of Otolaryngology, University of Cincinnati/Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. meymorch@privat.dk
authors.forename: Kumaresh
authors.initials: K
authors.lastname: Krishnamoorthy
authors.forename: Myles L
authors.initials: ML
authors.lastname: Pensa
authors.forename: Ravi N
authors.initials: RN
authors.lastname: Samy
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000328:Adult; D000368:Aged; D018786:Bone Substitutes / Q000009:adverse effects*; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology; D017577:Cutaneous Fistula / Q000209:etiology; D017886:Durapatite / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010579:Petrous Bone / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology
chemical_list: D018786:Bone Substitutes; D017886:Durapatite