Application value of calcium phosphate cement in complete cranial reconstructions of microvascular decompression craniectomies

J Plast Reconstr Aesthet Surg. 2023 Oct:85:210-216. doi: 10.1016/j.bjps.2023.06.065. Epub 2023 Jul 3.

Abstract

Objective: To investigate the application value of calcium phosphate cement (CPC) in repairing cranial defects during microvascular decompression (MVD) surgery via the retrosigmoid approach.

Methods: A retrospective study was carried out on patients who underwent MVD. According to the two different cranial reconstruction methods, patients were divided into a titanium mesh (TM) group and a CPC group. We compared in the two groups the length of postoperative hospital stay, the incidence of postoperative cerebrospinal fluid (CSF) leakage, the number of patients with suspected postoperative intracranial infection who underwent lumbar puncture, the number of patients with a definitive etiologic diagnosis of intracranial infection, and the imaging evaluation of plastic shape satisfaction.

Results: Patients in the CPC group had an average hospital stay of 9.15 ± 2.00 days, shorter than that in the TM group (10.69 ± 2.86 days), P < 0.001. In the TM group, the rate of plasticity satisfaction was 70/89 (78.65%), which was significantly lower than that in the CPC group (60/66, 90.91%), P = 0.040. Among the patients with a definitive etiologic diagnosis of intracranial infection, there were eight cases in the TM group and one case in the CPC group, and the difference was statistically significant, P = 0.049.

Conclusions: CPC is another viable alternative for complete cranial reconstructions of microvascular decompression craniectomies. The use of CPC does not increase the incidence of postoperative complications, such as CSF leakage and intracranial infection, and can reduce the average length of hospital stay and the incidence of etiologic diagnosis of intracranial infection. Furthermore, the evaluation of the plastic shape is satisfactory.

Keywords: Calcium phosphate cement; Cranial reconstructions; Microvascular decompression; Titanium mesh.

MeSH terms

  • Bone Cements / therapeutic use
  • Calcium Phosphates / therapeutic use
  • Cerebrospinal Fluid Leak / epidemiology
  • Cerebrospinal Fluid Leak / surgery
  • Craniotomy / methods
  • Humans
  • Microvascular Decompression Surgery*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Skull / surgery

Substances

  • Bone Cements
  • Calcium Phosphates