J Korean Neurotraumatol Soc. 2010 Jun;6(1):53-56. Korean.
Published online Jun 30, 2010.
Copyright © 2010 Journal of Korean Neurotraumatology Society
Original Article

Clinical Application of the Calcium Phosphate Cement (PolyBone®) for the Skull Bone Defects after Microvascular Decompression

Tae Yeon Won, MD, Kyung Jin Lee, MD, Chul Bum Cho, MD, Jong Yang Oh, MD, Hae Kwan Park, MD, Chung Kee Chough, MD, Won Il Joo, MD and Hyoung Kyun Rha, MD
    • Department of Neurosurgery, Yeouido ST' Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Received February 25, 2010; Revised March 11, 2010; Accepted March 25, 2010.

Abstract

Objective

Skull bone defects after microvascular decompression (MVD) were usually troublesome to the patients and surgeons. Recently, the use of calcium phosphate cements has become more common in craniofacial surgery because of several advantages. We retrospectively studied clinical usefulness of newly developed calcium phosphate cements (PolyBone®, Kyeung-won med., Seoul, Korea) in cranial reconstruction after MVD operation.

Methods

From January 2007 to December 2008 we performed retrosigmoid craniotomy in 20 patients with trigeminal neuralgia or hemifacial spasm. Calcium phosphate cements was used as a bone mineral substitute to repair the surgically induced bone defects in cranium.

Results

Mean follow up period was 12.15±4.35 months. There was no inflammatory reaction surrounding the implanted materials and no air or cerebrospinal fluid leakage. Postoperative plain x-ray of skull showed good healing and shaping of suboccipital bone at the surgical defect in all patients. The material could be seen as a dense, radio-opaque structure without the material artifacts.

Conclusion

We have demonstrated calcium phosphate cement is useful to repair and augment the surgically induced bone defects for cranio-facial surgery especially for small defects of the after MVD.

Keywords
Microvascular decompression; Skull bone defect; Calcium phosphate cement

Figures

FIGURE 1
Post operative radiologic findings after reconstructive surgery. A: Postoperative X-ray shows bone flap fixed by screws and plates and filling with calcium phosphate cement (Polybone®, Kyeung-won med., Seoul, Korea) polybone at the defect site. B: Three-dimensional CT scan at 3 months after surgery shows no bony defect. C: Postoperative bone setting CT. Calcium phosphate cement integrated with bone flap and defected site. The margin between bone flap and defected site is not obvious. D: The enhanced CT shows no definite abnormal enhancement around the operation site.

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