Removal of hydroxyapatite cement from cadaveric temporal bones after transtemporal surgery

Hydroxyapatite cement cranioplasty for translabyrinthine surgery: A single institution experience

OBJECTIVE

To assess complication rates in hydroxyapatite cement (HAC) cranioplasty for translabyrinthine acoustic surgery compared with historical controls.

METHODS

Retrospective chart review of patients undergoing de novo translabyrinthine surgery with HAC cranioplasty without concurrent adipose tissue graft or additional material between 2010 and 2017 at a tertiary otology center.

RESULTS

Fifty-two patients underwent HAC cranioplasty during the study period. The average length of follow-up was 30.5 months. HAC cranioplasty was associated with acceptable rates of cerebrospinal fluid leak (3.8%), wound or intracranial infection (5.8%), need for unplanned revision surgery (9.6%), and all complications (15.3%). All complications occurred within 5 months of surgery. No delayed wound infections or implant extrusions occurred.

CONCLUSION

HAC cranioplasty has an acceptable complication profile for translabyrinthine surgery and is a viable alternative to abdominal fat grafting without associated donor site morbidity.

LEVEL OF EVIDENCE

4 Laryngoscope, 130:206-211, 2020.

Hydroxyapatite bone cement for suboccipital retrosigmoid cranioplasty: A single institution case series

OBJECTIVE

To report rates of cerebrospinal fluid leak, wound infection, and other complications after repair of retrosigmoid craniotomy with hydroxyapatite bone cement.

METHODS

Retrospective case review at tertiary referral center of patients who underwent retrosigmoid craniotomy from 2013 to 2016 with hydroxyapatite cement cranioplasty.

OUTCOME MEASURES

Presence of absence of cerebrospinal fluid leak, wound infection, and other complications.

RESULTS

Twenty cases of retrosigmoid craniotomy repaired with hydroxyapatite cement were identified. Median length of follow up was 9.8months. No cases of cerebrospinal fluid leak were identified. One patient developed a wound infection which was thought to be related to a chronic inflammatory response to the implanted dural substitute. No other major complications were noted.

CONCLUSIONS

A method and case series of suboccipital retrosigmoid cranioplasty using hydroxyapatite cement and a are reported. Hydroxyapatite cement cranioplasty is a safe and effective technique for repair of retrosigmoid craniotomy defects.