Proliferation rate of human osteoblast-like cells on alloplastic biomaterials and their clinical application for the transnasal duraplasty procedure

The possibility of transmission of slow virus infection (HIV) and Creutzfeld-Jakob disease by cadaveric dura implants makes it necessary to find synthetic, absorbable materials for the reconstruction of the dura mater. Various procedures with autologous or alloplastic material are described. Four commercially available biomaterials were choosen to study the proliferation rate and the biocompatibility of human osteoblast-like cells (HOB-like cells) on 2- dimensional material by biochemical analysis. With a proliferation assay, the viability and the proliferation capacity of osteoblast-like cells were evaluated. A clinical trial was added to study resorbable fleece as one of the previously tested biomaterial in a small patient group (8 patients) to close anterior cranial fossa dura defects. The results of the proliferation assay showed the highest proliferation rate of HOB-like cells on resorbable fleece. All patients in our clinical trial with anterior cranial fossa dura defects were successfully treated with resorbable fleece. There was no evidence for persisting cerebrospinal fluid rhinorrhea or foreign body reaction after the period of wound healing. The present study demonstrated an excellent biocompatibility of resorbable fleece. The vicryl fleece is an alternative alloplastic material for endonasal closure of defined substantial defects of the dura with cerebrospinal fluid.