[Why a hydroxyapatite cranioplasty can be used to repair a cranial bone defect in children: Experience of 19 cases]

Introduction: The use of an autologous bone graft to repair a cranial bone defect is sometimes impossible in pediatric cases. CUSTOMBONE^® made with hydroxyapatite is a good alternative in these indications for neurosurgeons.

Material and methods: We present a pediatric series of 19 children who benefited from a cranioplasty using CUSTOMBONE^®. Their ages ranged between 8 months and 13 years with a mean of 6 years and 2 months. The most frequent indication was a cranioplasty after a post-traumatic decompressive craniectomy.

Results: No complications were reported. Cosmetic outcome was satisfactory in all patients. Only one plasty needed to be changed after a severe head trauma during the postoperative period. The assessment of cerebral blood flow was improved in all patients postoperatively. Complete ossification of the plasty is a long process. The mean time for the ossification to begin was 13 months (range: 3-22 months). The mean follow-up was 2.7 years.

Discussion: The excellent integration of the prosthesis is related to the accuracy of the reconstruction of the preoperative model. The minimum thickness of the plasty (4mm) could represent a challenge in very young children. One limitation is the cost, which remains high.

Conclusion: CUSTOMBONE^® met the criteria of protection and restoration of the normal intracranial physiology with good cosmetic results, which are necessary qualities for excellent clinical outcome.