LAUSR

INTRODUCTION In pediatric cases, the use of autologous bone tissue to repair cranial bone defects is often impossible. The synthetic hydroxyapatite bone substitute (CUSTOMBONE®) can be a good alternative especially in case of a large bone defect that has to be repaired. MATERIALS AND METHODS The present study focuses on a pediatric series of 30 children who underwent cranioplasty with a CUSTOMBONE® implant. Patient age ranged from 8 months to 16 years, with a mean age of 7 years and 8 months. The most common indication for cranioplasty was post-traumatic decompressive craniectomy. RESULTS No complications were reported. Cosmetic results were satisfactory in every patient. Only one implant had to be changed after a severe head trauma due to an epileptic seizure in the early postoperative period. In all patients, cerebral blood flow improved during the postoperative phase. Complete implant osteointegration is a long process as mean time to begin was 13 months (range: 3-22 months). Mean patient follow-up was 6,7 years. DISCUSSION Successful prosthesis integration depends on the accuracy of the preoperative model. The minimum thickness of the implant (4 mm) represent a challenge in very young children but we used it with success in this series. Moreover, high costs represent another limitation for its use. CONCLUSION In our opinion, the CUSTOMBONE® implant meets all necessary conditions for good clinical outcome: excellent protective properties, restoration of normal intracranial physiology, satisfactory cosmetic results, a good integration in the autologous bone and a good resistance in case of trauma.