title: [Why a hydroxyapatite cranioplasty can be used to repair a cranial bone defect in children: Experience of 19 cases].
abstract: BACKGROUND
  The use of an autologous bone graft to repair a cranial bone defect is sometimes impossible in pediatric cases. CUSTOMBONE®made with hydroxyapatite is a good alternative in these indications for neurosurgeons.
  
  
  METHODS
  We present a pediatric series of 19 children who benefited from a cranioplasty using CUSTOMBONE®. Their ages ranged between 8 months and 13 years with a mean of 6 years and 2 months. The most frequent indication was a cranioplasty after a post-traumatic decompressive craniectomy.
  
  
  RESULTS
  No complications were reported. Cosmetic outcome was satisfactory in all patients. Only one plasty needed to be changed after a severe head trauma during the postoperative period. The assessment of cerebral blood flow was improved in all patients postoperatively. Complete ossification of the plasty is a long process. The mean time for the ossification to begin was 13 months (range: 3-22 months). The mean follow-up was 2.7 years.
  
  
  CONCLUSIONS
  The excellent integration of the prosthesis is related to the accuracy of the reconstruction of the preoperative model. The minimum thickness of the plasty (4mm) could represent a challenge in very young children. One limitation is the cost, which remains high.
  
  
  CONCLUSIONS
  CUSTOMBONE®met the criteria of protection and restoration of the normal intracranial physiology with good cosmetic results, which are necessary qualities for excellent clinical outcome.
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital neurologique Pierre-Wertheimer, 69, boulevard Pinel, 69677 Bron, France.
authors.forename: P-A
authors.initials: PA
authors.lastname: Beuriat
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital neurologique Pierre-Wertheimer, 69, boulevard Pinel, 69677 Bron, France.
authors.forename: A
authors.initials: A
authors.lastname: Szathmari
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital neurologique Pierre-Wertheimer, 69, boulevard Pinel, 69677 Bron, France.
authors.forename: B
authors.initials: B
authors.lastname: Grassiot
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital neurologique Pierre-Wertheimer, 69, boulevard Pinel, 69677 Bron, France.
authors.forename: F
authors.initials: F
authors.lastname: Di Rocco
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital neurologique Pierre-Wertheimer, 69, boulevard Pinel, 69677 Bron, France. Electronic address: carmine.mottolese@chu-lyon.fr.
authors.forename: C
authors.initials: C
authors.lastname: Mottolese
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000379:methods; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D012886:Skull / Q000601:surgery*; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
chemical_list: D017886:Durapatite
keywords: Bone defect; Cranioplasty; Hydroxyapatite; Pediatric; Perte de substance osseuse; Plastie crânienne; Pédiatrie