{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T11:42:18Z","timestamp":1771069338377,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,1,6]],"date-time":"2017-01-06T00:00:00Z","timestamp":1483660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long\u2010term safety and efficacy in repairing translabyrinthine skull\u2010base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case\u2010control study (primary study arm); prospective cross\u2010sectional study of patients not examined within the last 5 years (secondary arm). Setting: tertiary\u2010care neurotology private practice and academic practice (two centers).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Hydroxyapatite cement implanted following translabyrinthine approach, with or without fat graft, was included. Combined approaches were excluded. Implant\u2010associated adverse events were defined as 1) CSF leaks requiring reoperation or spinal drainage, and (2) infections requiring reoperation. Patients not examined within 5 years were interviewed by telephone to update their condition. Incidence of adverse events was compared to published data for translabyrinthine cranioplasty using fat graft alone. Implant survival analysis was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study cohort included 369 HAC implants in the same number of patients. There were seven CSF leaks and seven infections. Combined (<jats:italic>n<\/jats:italic> = 14) incidence of adverse events was 3.8% (2.09%, 6.28%). Compared to fat graft alone, the adverse events associated with HAC were fewer (<jats:italic>P<\/jats:italic> &lt; 0.001). Up to 15 years (5,475 days), HAC cement maintained 95% adverse event\u2010free survival. There were no cases of meningitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cranioplasty using HAC with autologous fat following translabyrinthine skull\u2010base surgery is safer and more effective than fat graft alone, up to 15 years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 127:2120\u20132125, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26403","type":"journal-article","created":{"date-parts":[[2017,1,6]],"date-time":"2017-01-06T10:14:27Z","timestamp":1483697667000},"page":"2120-2125","source":"Crossref","is-referenced-by-count":15,"title":["Hydroxyapatite cement cranioplasty following translabyrinthine approach: Long\u2010term study of 369 cases"],"prefix":"10.1002","volume":"127","author":[{"given":"Peter G.","family":"Volsky","sequence":"first","affiliation":[{"name":"Pittsburgh Ear Associates, Philadelphia Pennsylvania"},{"name":"Division of Otolaryngology, Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A.","family":"Hillman","sequence":"additional","affiliation":[{"name":"Pittsburgh Ear Associates, Philadelphia Pennsylvania"},{"name":"Division of Otolaryngology, Philadelphia Pennsylvania"},{"name":"Allegheny Health Network, Pittsburgh, Philadelphia Pennsylvania"},{"name":"Department of Otolaryngology Temple University Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kellen J.","family":"Stromberg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Temple University Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farrel J.","family":"Buchinsky","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas A.","family":"Chen","sequence":"additional","affiliation":[{"name":"Pittsburgh Ear Associates, Philadelphia Pennsylvania"},{"name":"Allegheny Health Network, Pittsburgh, Philadelphia Pennsylvania"},{"name":"Department of Otolaryngology Temple University Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal M.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Western Reserve Hospital Cuyahoga Falls Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mois\u00e9s A.","family":"Arriaga","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Baton Rouge Louisiana"},{"name":"Neurosurgery, Baton Rouge Louisiana"},{"name":"Louisiana State University New Orleans, Baton Rouge Louisiana"},{"name":"CNC Hearing and Balance Center, New Orleans, Baton Rouge Louisiana"},{"name":"Our Lady of the Lake Hearing and Balance Center, Baton Rouge Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,1,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1224777"},{"key":"e_1_2_7_3_1","first-page":"47","article-title":"Hydroxyapatite cement: a new method for achieving watertight closure in transtemporal surgery","volume":"15","author":"Kamerer DB","year":"1994","journal-title":"Am J Otol"},{"key":"e_1_2_7_4_1","first-page":"465","article-title":"Indications for hydroxyapatite cement reconstruction in lateral skull base surgery","volume":"16","author":"Kveton JF","year":"1995","journal-title":"Am J Otol"},{"key":"e_1_2_7_5_1","unstructured":"United States Code: Title 21. 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