Endoscopic Reconstruction of Frontal, Cribiform and Ethmoid Skull Base Defects

Author(s):  
David Chin ◽  
Richard J. Harvey
2014 ◽  
Vol 150 (5) ◽  
pp. 730-738 ◽  
Author(s):  
Ethan Soudry ◽  
Justin H. Turner ◽  
Jayakar V. Nayak ◽  
Peter H. Hwang

Skull Base ◽  
2008 ◽  
Vol 18 (06) ◽  
pp. 385-394 ◽  
Author(s):  
Ivan El-Sayed ◽  
Fredrick Roediger ◽  
Andrew Goldberg ◽  
Andrew Parsa ◽  
Michael McDermott

2021 ◽  
Vol 12 ◽  
pp. 215265672110092
Author(s):  
Ghassan Alokby ◽  
Kholoud Mohammed AlAmari ◽  
Jamal Mohammed S. Abdullah ◽  
Mohammed Tayed Hazazi ◽  
Fawaz Makki

Background Various graft materials that are classified as autografts, xenografts, and allografts based on their origin have been used to endoscopically repair skull base defects. Tutoplast® (Tutogen Medical GmbH), an allogeneic natural collagen matrix, is processed through chemical sterilization that preserves tissue biocompatibility and structural integrity. Objective To study the safety and efficacy of Tutoplast Fascia Lata and Tutoplast Temporalis Fascia® as primary graft materials in the endoscopic reconstruction of skull base defects of different sizes and etiologies and to compare the outcomes with those of other traditional graft materials based on our experience. Methods This is a multi-center retrospective chart review of patients who underwent cerebrospinal fluid leak (CSF) endoscopic reconstruction with Tutoplast Fascia Lata or Tutoplast Temporalis Fascia as either a stand-alone reconstruction material or a part of a multilayer reconstruction depending on the defect at Prince Sultan Military Medical City and King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia, between 2017 and 2020. Our inclusion criteria were CSF leak repair with Tutoplast and a transnasal endoscopic approach. We reviewed demographic data, intraoperative and postoperative complications, repair materials, repair failure, defect size and location. Results Tutoplast® was used as the primary graft material in 33 cases. Our main outcome was repair success with lack of post operative CSF leak, observed in 30 cases (90.9%). There was no significant association between postoperative CSF leaks and factors including different defect sizes, defect sites, demographic data, hospitalization duration, or postoperative radiation in oncological cases. Conclusion Tutoplast alone or in combination with other materials can be used safely and effectively for skull base defects repair.


Author(s):  
Adam M. Zanation ◽  
Ricardo L. Carrau ◽  
Carl H. Snyderman ◽  
Amin B. Kassam ◽  
Paul A. Gardner ◽  
...  

2019 ◽  
Vol 133 (10) ◽  
pp. 889-894
Author(s):  
C Carnevale ◽  
M Tomás-Barberán ◽  
G Til-Pérez ◽  
J Ibañez-Domínguez ◽  
D Arancibia-Tagle ◽  
...  

AbstractBackgroundThe indications for expanded endoscopic transnasal approaches continue to increase, with more complex skull base defects needing to be repaired. This study reviews the management of large anterior skull base defects with opening of the sellar diaphragm.MethodA prospective analysis of endonasal endoscopic surgery carried out at Son Espases University Hospital between January 2013 and December 2018 was performed. The analysis included only the cases with a significative intra-operative cerebrospinal fluid leak. In all cases, reconstruction was performed by combining the gasket seal technique with a pedicled mucosal endonasal flap.ResultsTwenty-eight patients were included. The mucoperiosteal nasoseptal flap, the lateral wall flap and the middle turbinate flap were used in 13, 8 and 7 patients, respectively, combined with the gasket seal technique. One case of post-operative cerebrospinal fluid leak was observed (3.57 per cent).ConclusionThe combination of a gasket seal with an endonasal mucosal flap is an excellent technique for repairing large anterior skull base defects.


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