Complications of hydroxyapatite use for transnasal closure of cerebrospinal fluid leaks.

Abstract

BACKGROUND:

Hydroxyapatite cement (HAC) was first introduced in the 1980s as a new method for bone replacement. However, it has not been recommended for use in areas exposed to air. Despite this, surgeries have been performed using HAC to close nasal/sinus cerebrospinal fluid (CSF) leaks or in the treatment of encephaloceles.

METHODS:

This study retrospectively documented four patients in whom HAC was used for closure of ethmoid and sphenoid sinus CSF leaks.

RESULTS:

This study showed that exposed hydroxyapatite could be extremely problematic resulting in scarring, chronic granulation, infection, and prolonged healing. Oftentimes, revision surgery was necessary to help control the reaction to hydroxyapatite.

CONCLUSION:

Because of the frequent complications occurring with use of hydroxyapatite in the paranasal sinuses, its use should be limited to selected individuals in whom difficulty in achieving closure of the CFS leak could be anticipated and in whom adequate tissue coverage could be provided.

• Authors: James A Stankiewicz, Abhay M Vaidy, Jam M Chow, Guy Petruzzelli
• Journal: American journal of rhinology (Am J Rhinol) 2002 Nov-Dec Vol. 16 Issue 6 Pg. 337-41 ISSN: 1050-6586 [Print] United States
• PMID: 12512909 (Publication Type: Case Reports, Journal Article)

Chemical References

• Biocompatible Materials
• Durapatite

Topics

• Aged
• Biocompatible Materials (adverse effects)
• Cerebrospinal Fluid Rhinorrhea (diagnostic imaging, therapy)
• Durapatite (adverse effects)
• Ethmoid Sinus (surgery)
• Female
• Humans
• Male
• Middle Aged
• Prosthesis Implantation (adverse effects)
• Radiography
• Reoperation
• Retrospective Studies
• Sphenoid Sinus (surgery)
• Treatment Outcome