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Hydroxyapatite cement cranioplasty following translabyrinthine approach: Long-term study of 369 cases
Journal article   Peer reviewed

Hydroxyapatite cement cranioplasty following translabyrinthine approach: Long-term study of 369 cases

Peter G Volsky, Todd A Hillman, Kellen J Stromberg, Farrel J Buchinsky, Douglas A Chen, Neal M Jackson and Moisés A Arriaga
The Laryngoscope, v 127(9), pp 2120-2125
Sep 2017
DOI: https://doi.org/10.1002/lary.26403
PMID: 28059442
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Adipose Tissue - transplantation Case-Control Studies Cerebrospinal Fluid Leak - epidemiology Cerebrospinal Fluid Leak - etiology Cerebrospinal Fluid Leak - surgery Craniotomy - adverse effects Craniotomy - methods Cross-Sectional Studies Ear, Inner - surgery Follow-Up Studies Humans Hydroxyapatites - adverse effects Incidence Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - surgery Prospective Studies Reconstructive Surgical Procedures - adverse effects Reconstructive Surgical Procedures - methods Reoperation - statistics & numerical data Retrospective Studies Skull Base - surgery Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology Surgical Wound Infection - surgery Transplantation, Autologous - methods Treatment Outcome
To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections. Retrospective case-control study (primary study arm); prospective cross-sectional study of patients not examined within the last 5 years (secondary arm). tertiary-care neurotology private practice and academic practice (two centers). Hydroxyapatite cement implanted following translabyrinthine approach, with or without fat graft, was included. Combined approaches were excluded. Implant-associated adverse events were defined as 1) CSF leaks requiring reoperation or spinal drainage, and (2) infections requiring reoperation. Patients not examined within 5 years were interviewed by telephone to update their condition. Incidence of adverse events was compared to published data for translabyrinthine cranioplasty using fat graft alone. Implant survival analysis was performed. The study cohort included 369 HAC implants in the same number of patients. There were seven CSF leaks and seven infections. Combined (n = 14) incidence of adverse events was 3.8% (2.09%, 6.28%). Compared to fat graft alone, the adverse events associated with HAC were fewer (P < 0.001). Up to 15 years (5,475 days), HAC cement maintained 95% adverse event-free survival. There were no cases of meningitis. Cranioplasty using HAC with autologous fat following translabyrinthine skull-base surgery is safer and more effective than fat graft alone, up to 15 years after surgery. 4. Laryngoscope, 127:2120-2125, 2017.

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13 citations in Web of Science
15 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Medicine, Research & Experimental
Otorhinolaryngology
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