Adverse facial edema associated with off-label use of recombinant human bone morphogenetic protein–2 in cranial reconstruction for craniosynostosis

Case report

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✓The authors present a case of scalp and facial edema following craniofacial reconstruction for metopic craniosynostosis in which recombinant human bone morphogenetic protein–2 (rhBMP-2) was used to treat cranial defects related to the frontoorbital reconstruction. The extent of swelling, the onset, and duration were unusual for such cases and suggested a possible role of rhBMP-2 in inducing a local inflammatory response. The edema rapidly resolved after the patient underwent surgery to remove the rhBMP-2 implants.

Abbreviations used in this paper: BMP = bone morphogenetic protein; FDA = Food and Drug Administration; rhBMP-2 = recombinant human BMP–2.

Article Information

Address correspondence to: M. Mohsin Shah, M.D., Division of Neurosurgery, University of Missouri–Columbia, One Hospital Drive, N521, Columbia, Missouri 65203. email:

© AANS, except where prohibited by US copyright law.



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    Photograph of the patient obtained on postoperative Day 5, demonstrating gross craniofacial edema.



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