Lorenz Robert R, Papay Frank A, Jatla Muralidhar, Barthel Steven W, Seeley Brook M, Ulusal Betul G
Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
J Craniofac Surg. 2002 Nov;13(6):802-8. doi: 10.1097/00001665-200211000-00016.
Hydroxyapatite cement (HAC) has been shown to osseoconduct and may even osseoconvert. These properties render it suitable for repairing cranial defects in growing children. The objective of this pilot study was to determine if growth is restricted after HAC reconstruction in a growing, nonprimate, animal model. Frontoparietal craniotomies were performed on 10 4-week-old Yorkshire piglets. In 3 control piglets, the bone flap was resutured; in 7 experimental piglets, the defect was reconstructed with HAC. Analysis 6 months after surgery included craniometric measurements, biomechanical testing, and histological sectioning. Nine craniofacial measurements did not differ between controls and experimental animals. The mean midline-to-temporal line distance contralateral to the defect was 20% larger in the experimental group (P = 0.006), however, and experimental animals had a larger difference between right and left orbital breadths (+3% difference versus -1% difference; P = 0.003). The mean stiffness of the HAC-repaired defect was not different from the contralateral side in contrast to the resutured bone flap in controls, which was significantly less stiff than unoperated bone (162 N/mm compared with 358 N/mm; P < 0.05). Based on our animal model, HAC seems to be a sound alternative method of craniotomy reconstruction in the growing skull.
羟基磷灰石骨水泥（HAC）已被证明具有骨传导性，甚至可能发生骨诱导。这些特性使其适用于修复正在生长的儿童的颅骨缺损。这项初步研究的目的是确定在一个正在生长的非灵长类动物模型中，HAC重建后生长是否受到限制。对10只4周龄的约克郡仔猪进行额顶开颅手术。3只对照仔猪的骨瓣进行了重新缝合；7只实验仔猪的缺损用HAC进行了重建。术后6个月的分析包括颅骨测量、生物力学测试和组织切片检查。对照组和实验组动物的9项颅面测量结果没有差异。然而，实验组缺损对侧的中线到颞线平均距离比对照组大20%（P = 0.006），并且实验组动物左右眶宽之间的差异更大（+3%对-1%；P = 0.003）。与对照组重新缝合的骨瓣相比，HAC修复缺损的平均刚度与对侧没有差异，对照组重新缝合的骨瓣刚度明显低于未手术的骨（分别为162 N/mm和358 N/mm；P < 0.05）。基于我们的动物模型，HAC似乎是正在生长的颅骨开颅重建的一种可靠替代方法。
