Thursday, January 6, 2022

Optimal Multiple-Layered Anterior Skull Base Reconstruction Using a 360° Suturing Technique

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Oper Neurosurg (Hagerstown). 2022 Jan 1;22(1):e1-e6. doi: 10.1227/ONS.0000000000000013.

ABSTRACT

BACKGROUND: Advances in technique and instrumentation have improved outcomes after resection of anterior skull base tumors. However, cerebrospinal fluid (CSF) leak occurs in 4%-20% of patients. To reduce the risk of CSF leak, we have developed a novel reconstruction technique that consists of a 4-layered graft with patchwork suturing and hard material.

OBJECTIVE: To evaluate the effectiveness of this reconstruction technique when used for resection of anterior skull base tumors.

METHODS: This case series included 59 patients with anterior skull base tumors in whom the 4-layered closure technique was used. The main outcome measures were complications, including CSF leak, meningitis, postoperative bleeding, and infection.

RESULTS: There were no CSF leak cases or serious complications after closure of the anterior skull base using t he 4-layered technique.

CONCLUSION: Closure of the anterior skull base in 4 layers prevented CSF leak and was not associated with any serious complications. However, further studies in larger numbers of patients are needed to confirm our outcomes using this closure method.

PMID:34982903 | DOI:10.1227/ONS.0000000000000013

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