Commentary

Drs. Zanetti and Nassif present their initial experience with the use of flexible hydroxyapatite sheets to repair lateral skull base defects. They prospectively reviewed the outcomes of seven patients with mastoid defects, 3 cm or less, resulting from traumatic, iatrogenic, or infectious causes. After a mean follow-up of 27.5 months, none of the patients suffered any complications related to the graft such as infection, extrusion, or cerebrospinal fluid leaks. All patients exhibited a reasonable anatomic contour on postoperative computed tomographic scans. Although this experience is limited, flexible, osteoconductive hydroxyapatite sheets offer a viable alternative for the repair of skull base defects, and further clinical evaluation is warranted.