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Hydroxyapatite cement in craniofacial reconstruction.

D J Verret1, Yadranko Ducic, Lance Oxford

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 20, 2005
PubMed
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Hydroxyapatite cements are safe for craniofacial reconstruction, but risks increase with frontal sinus placement, beneath incisions, or after radiation. Different cement types showed varying infection and reaction rates.

Area of Science:

  • Craniofacial surgery
  • Biomaterials science
  • Reconstructive surgery

Background:

  • Hydroxyapatite cements are utilized in craniofacial reconstruction.
  • Long-term efficacy and complication factors require further evaluation.

Purpose of the Study:

  • To assess the long-term effectiveness of hydroxyapatite cement in craniofacial reconstruction.
  • To investigate the influence of radiation, implant location, and cement type on outcomes.

Main Methods:

  • Retrospective chart review of 102 patients undergoing craniofacial reconstruction with hydroxyapatite cements (September 1997 - April 2004).
  • Data collected included cement type, defect size, complications, implant removal, and reasons for removal.

Main Results:

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  • Seven patients required complete implant removal (Norian, Mimix), and four needed partial removal due to foreign body reaction (Norian, Bone source).
  • Five implant removals occurred in patients who received postoperative radiation.
  • Statistically significant differences in infection and foreign body reaction rates were observed between cement types.

Conclusions:

  • Hydroxyapatite cements are generally safe for craniofacial reconstruction.
  • Increased risk of implant infection is associated with frontal sinus reconstruction, placement beneath coronal incisions, and postoperative radiation.
  • Avoid frontal sinus implantation; exercise caution with placement near incisions or in patients receiving radiation, especially with boost doses.