Complications of hydroxyapatite bone cement reconstruction of retrosigmoid craniotomy: two cases.
Hydroxyapatite bone cement is a versatile material used to reconstruct many types of bony surgical defects, and its applications have been widely reported in the literature. Still, complications of its use do occur. We describe 2 cases of hydroxyapatite resorption and subsequent seroma formation in patients who had undergone retrosigmoid craniotomy. The presentation in both cases mimicked a CSF leak. In both cases, the fragmented cement was removed, and the patient experienced no further complications. While hydroxyapatite cement is a highly useful product for the reconstruction of some craniofacial or skull base defects, we believe that it should not be used for the reconstruction of retrosigmoid/suboccipital craniotomies because it is associated with unacceptably high complication rates. Surgeons must exercise caution in selecting candidates for hydroxyapatite reconstruction of cranial defects.
Benson
Aaron G
AG
Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Djalilian
Hamid R
HR
D000328:Adult; D001843:Bone Cements / Q000009:adverse effects*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery; D003399:Craniotomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D006882:Hydroxyapatites / Q000009:adverse effects*; D009464:Neuroma, Acoustic / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012086:Reoperation; D049291:Seroma / Q000139:chemically induced*
D001843:Bone Cements; D006882:Hydroxyapatites; C475044:hydroxyapatite cement