Using hydroxylapatite ceramic buttons covered with periosteum to prevent cerebrospinal fluid leakage: Technical note

BACKGROUND: Many attempts have been made to prevent cerebrospinal fluid (CSF) leakage, but the procedures proposed to date are troublesome and not promising. We describe a method of completely preventing CSF leakage using hydroxylapatite ceramics. METHODS: Exposed frontal sinus, mastoid air cells, and frontal base defects caused by fracture are covered with periosteum or fascia and plugged with a trimmed hydroxylapatite ceramic button. RESULTS: There was no CSF leakage, postoperative meningitis, or other complication related to the technique in a consecutive series of 25 patients treated using this procedure. CONCLUSION: The use of this easy and quick technique may prevent CSF leakage completely.