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Repair of Cranial Bone Defects in Children Using Synthetic Hydroxyapatite Cranioplasty (CustomBone)
Pierre-Aurélien Beuriat1, Laura-Nanna Lohkamp1, Alexandru Szathmari1
1Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, Lyon Cedex, France.
Insights
CustomBone, a synthetic hydroxyapatite implant, offers a viable solution for pediatric cranial bone defects when autologous bone is unsuitable. This study highlights its successful use in 30 children, showing good integration and cosmetic outcomes.
Area of Science:
- Biomaterials Science
- Pediatric Neurosurgery
- Craniofacial Reconstruction
Background:
- Autologous bone grafting is often not feasible for pediatric cranial bone defects.
- Synthetic hydroxyapatite bone substitute (CustomBone) presents a viable alternative, particularly for large defects.
Purpose of the Study:
- To evaluate the clinical outcomes of CustomBone implants in pediatric patients undergoing cranioplasty.
- To assess the safety, efficacy, and integration of CustomBone in a pediatric cohort.
Main Methods:
- A retrospective study of 30 pediatric patients (age 8 months to 16 years) who received CustomBone cranioplasty.
- Indications included post-traumatic decompressive craniectomy.
- Mean follow-up was 6.7 years.
Main Results:
- No major complications were reported; cosmetic results were satisfactory in all patients.
- One implant required revision due to severe head trauma.
- Improved cerebral blood flow was observed postoperatively; mean time to osteointegration was 13 months.
- Successful integration was achieved despite challenges with implant thickness in younger children.
Conclusions:
- CustomBone implants provide excellent protective properties and restore intracranial physiology.
- Satisfactory cosmetic results and good integration with autologous bone were achieved.
- The implant demonstrated good resistance to trauma, making it suitable for pediatric cranioplasty.
Background:
In pediatric cases, the use of autologous bone tissue to repair cranial bone defects is often impossible. The synthetic hydroxyapatite bone substitute (CustomBone) can be a good alternative, especially in case of a large bone defect that has to be repaired.
Methods:
This study focuses on a pediatric series of 30 children who underwent cranioplasty with a CustomBone implant. Patient age ranged from 8 months to 16 years, with a mean age of 7 years and 8 months. The most common indication for cranioplasty was posttraumatic decompressive craniectomy.
Results:
No complications were reported. Cosmetic results were satisfactory in every patient. Only 1 implant had to be changed after severe head trauma because of an epileptic seizure in the early postoperative period. In all patients, cerebral blood flow improved during the postoperative phase. Complete implant osteointegration is a long process because mean time to begin was 13 months (range, 3-22 months). Mean patient follow-up was 6.7 years. Successful prosthesis integration depends on the accuracy of the preoperative model. The minimum thickness of the implant (4 mm) represents a challenge in very young children, but we used it with success in this series. Moreover, high costs represent another limitation for its use.
Conclusions:
The CustomBone implant meets all necessary conditions for good clinical outcome: excellent protective properties, restoration of normal intracranial physiology, satisfactory cosmetic results, good integration in the autologous bone, and good resistance in case of trauma.
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