INDICATIONS FOR HYDROXYAPATITE CEMENT RECONSTRUCTION IN LATERAL SKULLBASE SURGERY

Preliminary data on the use of hydroxyapatite cement to restore crania l bone integrity has shown excellent results. Cranial base reconstruct ion has been accomplished for translabyrinthine, middle cranial fossa, and suboccipital craniectomy defects, as well as extensive temporal b one fractures. Fifteen patients have been followed for up to 2 years w ith no evidence of complication from use of the hydroxyapatite cement. Exposure to cerebrospinal fluid does not appear to alter its stabilit y, and pre-existing infection appears to be the only contraindication to its use. Stability of the cement has been confirmed by serial radio graphic analyses. This paper reviews the chemical structure and bioact ivity of hydroxyapatite cement and employs case studies to illustrate the applications of this new biomaterial in lateral skull base surgery .