Hydroxyapatite cement cranioplasty in translabrythine acoustic neuroma surgery

	OBJECTIVES: Hydroxyapatite cement cranioplasty (HAC)after translabrythine resection of acoustic neuroma is a promising new technique for wound reconstruction. This study reviews the efficacy of HAC for the prevention of cerebrospinal fluid (CSF) leakage and the long term wound outcomes of HAC versus abdominal fat graft (AFG) reconstruction METHODS: This retrospective study of 108 consecutive acoustic neuroma operated on by Pittsburgh Ear Associates used chart review, telephone interview and mail questionnaire data. Fifty-four patients received AFG dural repair, and 54 received HAC. RESULTS: Seven AFG patients (12.5%) had CSF leaks versus 2 (3.7%) of the overall group of 54 HAC patients. However, none (0%) of the 47 HAC patients has CSF leakage with current HAC techniques. HAC also produced significantly less postauricular wound depression and superior cosmetic results in comparison with AFG. Although HAC patients experiences less postoperative discomfort, wound complications requiring medical or surgical intervention were extremely uncommon in both groups. CONCULSION: HAC offers significant CSF leakage control and long-term cosmetic and comfort advantages over AFG alone. We recommend HAC as the standard closure technique for translabryrinthine acoustic neuroma surgery.

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