Complications of XXXX bone cement in secondary pediatric craniofacial reconstruction.

@entity692 @entity1 @entity281
@entity692 cement has become a popular alternative to bone grafts in reconstructing the calvarium. Although animal studies have shown promising results with use of @entity692 , @entity1 clinical studies have shown mixed results including significant rates of @entity281 . This is a retrospective chart review during a 7-year period (1997-2003) of 20 @entity1 who underwent secondary forehead cranioplasty with @entity692 cement (Norian Craniofacial Reconstruction System). Basic demographics including age, sex, and diagnosis were identified. Characteristics of the defects were recorded including size, location, and depth (full versus partial thickness). The volume of @entity692 and any adjunctive procedures were identified. The postoperative course was analyzed for length of follow-up and the presence of infections.Twenty @entity1 were identified in which Norian had been used and 3 @entity1 were lost to follow-up. Secondary forehead asymmetry was the most common presentation. The mean volume of @entity692 used was 24.4 mL. All @entity1 had initially acceptable aesthetic results. Of the 17 @entity1 , 10 (59%) ultimately had infectious complications. Infection occurred on a mean of 17.3 months after surgery (range, 4 mo to 4 y), and the mean amount of @entity692 used was 32.5 mL (infections) versus 14.3 mL (no infections). Of the 10 @entity1 with complications, 9 required surgical debridement and subsequent delayed reconstruction. Although @entity692 cement can yield excellent aesthetic results, its use in secondary reconstruction has yielded unacceptably high @entity281 rates leading to discontinuation of its use in this @entity1 population.
