Background:
The search for an ideal material for cranioplasty has been a very difficult quest.
Many materials have been advocated Hydroxyapatite seemed to gather many useful
characteristics; it is safe and does not advocate any toxic or immune
reactions. It also has the benefit of being both osteoconductive as well as
biocompatible. However, hydroxyapatite was not popularly used due to the putty
like consistency of the cement which leads to its settling. Objective:
The aim of this study is to evaluate using a technique in which hydroxyapatite
cement is applied to cranial defects ranging between 20-42cm2 after
reinforcement with polypropylene- polyester mesh. Methods:
Fourteen patients with different ages with cranial defects of variable sizes
due to different pathologies were included in this study. Hydroxyapatite cement
was applied to the defect over the fashioned polypropylene-polyester mesh after
exposure of the bony edges. Surgical results were then analyzed. Results:
This technique was conducted on 14 cases of different pathologies; the
cranioplasties ranged in size from 20 to 42 cm2 (mean= 30.85 cm2).
Surgical results revealed a satisfactory cosmetic outcome in all cases with no report
of infection or cerebrospinal fluid leak. Follow up ranged from 3-24 months
(mean 12.9 months). Conclusion: The use of mesh supported
hydroxyapatite cement proved to be a safe and convenient method in treating
patients suffering skull defects of various etiologies providing good cosmetic
result in addition to the simplicity in the technique. [Egypt J Neurol Psychiat
Neurosurg. 2012; 49(1): 53-57]
Key Words: skull
defect, polypropylene-polyester, hydroxyapatite, cranioplasty.
Correspondence to
Mohamed M. Fouad, Department of Neurosurgery, Cairo University, Egypt.
Tel.: +20227546361. Email: mmfoad@hotmail.com