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Hydroxyapatite cement resistant to fragmentation following full cerebrospinal fluid bathing

Michael G Muhonen1, Anna Lonyai, Franklin D Westhout

  • 1Neuroscience Institute, Children's Hospital of Orange County, Orange, CA 92868, USA. mmuhonen@aol.com

The Journal of Craniofacial Surgery
|January 25, 2008
PubMed

Insights

Hydroxyapatite cement effectively repaired a large skull defect in a child, resisting cerebrospinal fluid breakdown. This innovative cranioplasty offers a durable solution for complex pediatric skull reconstruction.

Area of Science:

  • Neurosurgery
  • Biomaterials Science
  • Pediatric Plastic Surgery

Background:

  • Cranioplasty implants often fail due to prolonged exposure to cerebrospinal fluid.
  • Pediatric skull defects require robust and long-lasting repair solutions.

Observation:

  • A 5-year-old boy presented with a significant skull defect and brain herniation due to trauma.
  • The defect involved the superior temporal and inferior parietal bones, with underlying dural defect.
  • Initial computed tomography revealed an expanding skull fracture.

Findings:

  • The cranial lesion was successfully repaired using OsteoVation hydroxyapatite cement.
  • Cerebrospinal fluid accumulation occurred initially but resolved after shunting device implantation.
  • The hydroxyapatite cement implant remained solid and intact at 2 and 12 months post-surgery.

Implications:

  • Hydroxyapatite cement demonstrates excellent durability and resistance to cerebrospinal fluid degradation in pediatric cranioplasty.
  • This case highlights a successful treatment strategy for complex pediatric skull defects with brain herniation.
  • The findings suggest hydroxyapatite cement as a viable alternative for cranioplasty in challenging pediatric cases.

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