Journal article
Endoscopic extrasellar skull base reconstruction using bioabsorbable plates
American journal of otolaryngology, Vol.42(1), pp.102750-102750
01/2021
DOI: 10.1016/j.amjoto.2020.102750
PMID: 33099231
Abstract
Many techniques have been utilized for reconstruction of the anterior skull base. Each method has advantages and disadvantages with respect to effectiveness, morbidity, strength, and cost. Rigid reconstruction may provide advantages in certain patients.
We evaluated all patients who had placement of rigid absorbable reconstruction plates in the anterior skull base in a variety of extrasellar locations and describe results and complications compared with other published techniques.
A retrospective review was conducted of consecutive patients at a tertiary referral institution who underwent endoscopic extrasellar skull base reconstruction, 2012–2019, using resorbable poly (D,L) lactic acid plates (Resorb-X Sellar Wall Plate; KLS Martin; Jacksonville, FL). Data reviewed included demographic information, indication for surgery, location and size of defect, pathology, peri-operative use of cerebrospinal fluid (CSF) diversion, postoperative complications, post-operative CSF leak, adjuvant therapy, and length of follow-up.
Twenty-four subjects and 25 operative procedures met inclusion criteria. Mean age was 53 years (range 11–77). Average BMI was 34 kg/m2. Mean follow-up time was 30 months (range 1–78). Indications for surgery were CSF rhinorrhea (spontaneous, post-traumatic, or iatrogenic) or reconstruction after tumor resection. Four cases were revision procedures. Twenty patients had lumbar drains placed intraoperatively. Only two nasoseptal flaps and two free mucosal grafts were used. None of the patients had a postoperative CSF leak. There was no mortality or morbidity related to the skull base reconstruction or implanted material.
The Resorb-X resorbable rigid plate provides an effective, customizable, bioabsorbable option that is easily manipulated for skull base reconstruction of defects of a variety of sizes in diverse locations. Reconstruction incorporating this plate provides an effective alternative to other previously described techniques.
•Rigid reconstruction of skull base defects is useful, is especially in cases of high BMI, a known risk factor for csf leak•The use of a bioabsorbable plate can be utilized not only in sellar defects but in extra-sellar defects•A bioabsorbable plate can be used regardless of defect size regardles, with large defects repaired by overlapping multiple plates•This technique can mitigate use of a nasoseptal flap and its consequent nasal morbidity with satisfactory csf leak outcomes
Details
- Title: Subtitle
- Endoscopic extrasellar skull base reconstruction using bioabsorbable plates
- Creators
- Scott C Seaman - Department of Neurosurgery, United States of AmericaMckay J Moline - Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States of AmericaScott M Graham - Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States of AmericaJeremy D.W Greenlee - Department of Neurosurgery, United States of America
- Resource Type
- Journal article
- Publication Details
- American journal of otolaryngology, Vol.42(1), pp.102750-102750
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjoto.2020.102750
- PMID
- 33099231
- ISSN
- 0196-0709
- eISSN
- 1532-818X
- Language
- English
- Date published
- 01/2021
- Academic Unit
- Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984068366202771
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