Repair of skull defects involving the mastoid sinus: The use of methv Imethacrylate cranioplasty

The use of acrylic cranioplasty in repairing bone defects involving air sinuses remains controversial for fear of infection. A series with acrylic repair of mastoid defects is described. Series: Sixty-two patients; schwannomas (27 vestibular, four trigeminal) and meningiomas (17) of the posterior fossa were the most common lesions. Technique: Defects were repaired with an onlay acrylic cranioplasty, secured with vault locking technique. Intravenous antibiotics and antibiotic irrigation were utilized; implants were not antibiotic impregnated. Sinus mucosa was cauterized with low power monopolar cautery, with bone wax impression and cranioplasty placement in the mastoid. Results: No implant infections occurred and none required removal. One patient developed delayed CSF rhinorrhea. One patient had a superficial infection of a neck wound for great vessel exposure prior to petrosectomy. treated with a short course of oral antibiotic.