Wednesday, September 15, 2021

Management of Large Dural Defect with CSF Leak in Hypertelorism Correction

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Ann Maxillofac Surg. 2021 Jan-Jun;11(1):136-139. doi: 10.4103/ams.ams_43_21. Epub 2021 Jul 24.

ABSTRACT

THE RATIONALE: Dural tear is a serious complication during hypertelorism corrective surgeries. Identifying the tear and managing requires considerable expertise. Managing large dural tears correctly is necessary to prevent cerebrospinal fluid (CSF)-related complications in craniofacial surgery.

PATIENT CONCERNS: The patient presented with hypertelorism as a part of the Tessier Cleft 0 and sought to correct the widely placed eyes.

DIAGNOSIS: Large critical-sized dural tear during modified box osteotomy surgery.

TREATMENT: Besides successful modified box osteotomy surgery, the critical-sized dural tear was managed with fascia lata and fibrin glue.

OUTCOMES: There was no CSF leak or related complication postsurgically indicating successful sealing and healing of the dural tear.

TAKE-AWAY LESSONS: The synergistic m echanism by which fascia lata graft and fibrin glue help to hermetically seal the critical-sized defect, especially when there are variable amounts of hydrostatic-hydrodynamic forces of CSF exerting pressure on the patched area, is discussed.

PMID:34522669 | PMC:PMC8407622 | DOI:10.4103/ams.ams_43_21

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