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Calcium phosphate cements in skull reconstruction: a meta-analysis.

Abstract：

BACKGROUND:This work addresses the controversy regarding the indications and results of calcium phosphate cements in skull reconstruction through a meta-analysis of the published literature. METHODS:A PubMed search for articles reporting the use of calcium phosphate cements for skull reconstruction was performed. Data collected included age, volume of cement, defect size, material used, length of follow-up, placement in communication with paranasal sinuses or in irradiated fields, and complications. RESULTS:Nineteen articles met the authors' inclusion criteria. The mean rates of complications were as follows: total complications, 13 percent (range, 0 to 62 percent); major complications, 9 percent (range, 0 to 62 percent); minor complications, 2 percent (range, 0 to 5 percent); infection, 5 percent (range, 0 to 22 percent); reoperation, 14 percent (range, 0 to 62 percent); and secondary surgery for contour correction, 1 percent (range, 0 to 12 percent). There was significant heterogeneity in the estimated rate of total and major complications, infection, and reoperation (p < 0.001), but minor complications and secondary contour correction had less heterogeneity (p = 0.58 and p = 0.78, respectively). Radiotherapy and communication with the paranasal sinuses significantly increased the complication rate (p < 0.05). Duration between surgery and complications averaged 17.5 months (range, 1 to 89 months). CONCLUSIONS:When mean complication rate and complication range of calcium phosphate cements in our meta-analysis were compared with previous large cranioplasty studies using methylmethacrylate or autogenous bone, calcium phosphate fared no better, and sometimes fared worse, than these other modalities. Calcium phosphate, therefore, should only be used selectively, and prospective long-term studies are needed to further refine its role in skull reconstruction.

journal_name

Plast Reconstr Surg

journal_title

Plastic and reconstructive surgery

authors

Afifi AM,Gordon CR,Pryor LS,Sweeney W,Papay FA,Zins JE

doi

10.1097/PRS.0b013e3181ead057

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

1300-1309

issue

eissn

0032-1052

issn

1529-4242

pii

00006534-201010000-00018

journal_volume

126

pub_type

杂志文章,meta分析,评审

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Calcium phosphate cements in skull reconstruction: a meta-analysis.