Skull Base 2010; 20(3): 157-161
DOI: 10.1055/s-0029-1246222
ORIGINAL ARTICLE

© Thieme Medical Publishers

A Novel Method of Translabyrinthine Cranioplasty Using Hydroxyapatite Cement and Titanium Mesh: A Technical Report

Nicholas C. Bambakidis1 , Charles Munyon1 , Alvin Ko2 , Warren R. Selman1 , Cliff A. Megerian1 , 2
  • 1Department of Neurological Surgery, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, Ohio
  • 2Department of Otolaryngology–Head and Neck Surgery, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, Ohio
Further Information

Publication History

Publication Date:
06 January 2010 (online)

ABSTRACT

We report a novel technique for closure using titanium mesh cranioplasty in addition to hydroxyapatite cement and abdominal fat graft for acoustic neuroma. We reviewed 15 patients who underwent translabyrinthine craniectomy for resection of acoustic neuroma. Hearing loss was documented prior to surgical procedure. Over 2 years, patients underwent titanium mesh and hydroxyapatite cranioplasty with abdominal fat graft. Participants included seven men and eight women, age range 38 to 65. Main outcome measures included cosmetic outcome and incidence of cerebrospinal fluid (CSF) leak. The lesion was right-sided in seven patients and left-sided in eight. Cosmetic outcome was excellent in all. There were no cases of CSF leak. Closure used one-third the hydroxyapatite required for traditional closure. Our technique yields cosmetic results equivalent to hydroxyapatite cement alone and a comparable incidence of CSF leakage without leaving a drain in place postoperatively. The technique is easy to adopt, is more cost-effective than hydroxyapatite cement cranioplasty alone, offers greater ease of access for reoperation, and does not preclude later implantation of bone-anchored hearing aid.

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Nicholas C BambakidisM.D. 

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