Contouring of cranial vault irregularities with hydroxyapatite cement: a clinical and experimental investigation.

The biocompatible hydroxyapatite cement (HAC) is a welcome alternative to the traditional use of autogenous bone for postoperative corrections of cranial vault irregularities. The authors performed experimental studies to show the safety and osseointegration capacity of HAC on animal models and confirm the osseous replacement without toxic reactions. The purpose of the current study was to analyze the clinical outcome after correction of secondary cranial vault irregularities with HAC. Twenty-one patients were treated for residual cranial frontal bone defects after craniotomy with HAC (Bone Source, Stryker Leibinger GmbH, D-79111 Freiburg, Germany). The average age was 38.5 years (range, 23-57 years). All of the patients were male. The average volume per patient was 53.83 g. The volume implanted ranged from 25 to 125 g; in all cases the dura was covered with bone. Irregularities resulted from sunken bone. The authors' clinical series demonstrates that a satisfactory and aesthetically pleasing result can be achieved in one surgical intervention in patients for surgical correction of postoperative cranial vault irregularities using HAC. It permits osseointegration, which makes it relatively resistant to infection. HAC is easy to apply and shape to suit individual needs. HAC is a welcome alternative to the traditional use of autogenous bone for postoperative corrections of cranial vault irregularities.