A correlation of the surgical anatomy of the dura to head and neck surgery

Willatt, D. J.; Yung, M. W.; Helliwell, T. R.

doi:10.1007/bf00464652

Cited by 7 publications

(5 citation statements)

References 1 publication

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“…Willatt et al reported skull base dura to range from 0.72 to 0.88 mm and found that the tegmen middle cranial fossa dura was significantly thinner than frontal sinus, cribriform plate, anterior cranial fossa dura, and posterior cranial fossa dura. 19 Histological cadaveric studies in human spine also found variability in dural thickness not just between different segments and levels of the spine but also between ventral and dorsal dura. Kwon et al studied cervical spine dura and found a significant negative correlation with age but no difference among genders in a cohort of nine cadavers.…”

Section: Discussionmentioning

confidence: 99%

Skull Base Dural Thickness and Relationship to Demographic Features: A Postmortem Study and Literature Review

Fam

Potash

et al. 2018

J Neurol Surg B

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Dural membrane is an important anatomic structure that surrounds and protects the entire central nervous system. Physical properties of the dura have many pathophysiological and therapeutic implications in cranial surgery, especially skull base disorders. The aim of this study is to investigate variation in skull base dural thickness and correlation with different demographic parameters. At the time of autopsy, the petrous apex dura with the underlying bone of 20 cadavers was harvested. Dural thickness was independently measured by two pathologists at the thinnest and thickest segments in the specimen. Correlational analyses were then performed to compare dural thickness with gender, age, neck circumference, height, weight, and body mass index (BMI). Mean, minimum, and maximum skull base dural thickness in our study was 0.36, 0.27, and 0.46 mm, respectively. Age demonstrated a negative correlation with dural thickness with significantly thinner dura in the older subjects, p = 0.01. There was a trend toward thinner dura in females that approached statistical significance, p = 0.06. No strong correlation could be found with body weight, height, neck circumference, or BMI. Our findings show a considerable intersubject and intrasubject variability in skull base dural thickness. Some demographic parameters also seem to impact dural thickness. Additional histological studies are needed for better understanding of the pathophysiological mechanisms pertaining to the tensile properties of the dural membrane.

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Section: Discussionmentioning

confidence: 99%

Skull Base Dural Thickness and Relationship to Demographic Features: A Postmortem Study and Literature Review

Fam

Potash

et al. 2018

J Neurol Surg B

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“…The outer layer is formed by the periosteum of the tabula interna, which is rich in blood and lymphatic vessels and nerves and the inner layer, the meningeal layer, lines the inside of the entire skull. Histological examination shows the similarity of these two layers [9] . The thickness of the dura varies depending on the location in the skull.…”

Section: Discussionmentioning

confidence: 92%

“…Folding the outer layer over the gap and suturing to the opposite dura border ( d ). dura mater is remarkably thicker in contrast to the dura covering the ethmoid sinus, the tegmen and the sigmoid sinus plate [9] . This has implications for the application of the proposed technique.…”

Section: Discussionmentioning

confidence: 92%

A Simple Technique for Bridging Small Cranial Dural Defects Without the Use of Grafts: Technical Note

Plazier¹,

Menovsky²,

Ridder³

2007

Minim Invasive Neurosurg

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A watertight closure of the dura is important in preventing post-operative complications. Various techniques are described to close small dura defects. We present a simple technique that uses on site homologues dura tissue to bridge small dura defects by separating the periosteum from the inner meningeal layer. This provides a low-cost, tension-free repair without the use of synthetic materials or need to harvest autologous materials.

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“…Metastasis cancer corrodes or invades the surrounding tissue. Since the dura thickness in the skull base was relatively thinner than other parts, [24] it was easier for cancer cells to breach the CSF leak-proof mechanism in the skull base. When the tumor is shrunken after surgery, the CSF may leak from those cracks made by cancer, and air may be drawn into the cranial space via the inverted soda bottle mechanism [16][17][18] or the ball valve mechanism.…”

Section: Discussionmentioning

confidence: 99%

Severe pneumocranium after gamma knife stereotactic radiosurgery for brain metastasis: A case report and literature review

Chen,

Lin

2024

Medicine

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Rationale: Gamma knife stereotactic radiosurgery (GKRS) is a recognized safe and effective treatment for brain metastasis; however, some complications can present significant clinical challenges. This case report highlights a rare occurrence of cerebrospinal fluid (CSF) leakage and pneumocranium following GKRS, emphasizing the need for awareness and prompt management of these complications. Patient concerns: A 35-year-old male with a history of malignant neoplasm of the lip in 2015 and perineural spread of malignancy into the left cavernous sinus was treated with GKRS in 2017. The patient was admitted emergently 39 days after discharge due to persistent headache and dizziness. Diagnoses: Brain computed tomography (CT) revealed diffuse bilateral pneumocranium alongside an observation of CSF leakage. Interventions: A surgical procedure involving a left frontal-temporal craniotomy was performed to excise a residual skull base tumor and repair the dura, guided by a navigator system. The conclusive pathological assessment revealed the presence of squamous cell carcinoma markers. Outcomes: The patient exhibited excellent tolerance to the entire procedure and experienced a prompt and uneventful recovery process. After surgery, the symptoms alleviated and CSF leak stopped. The follow-up image showed the pneumocranium resolved. Lessons: Pneumocranium due to early-stage post-GKRS is uncommon. The rapid tumor shrinkage and timing of brain metastasis spreading through the dura can lead to CSF leak and pneumocranium. We reviewed current treatment options and presented a successful craniotomy-based dura repair case.

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A correlation of the surgical anatomy of the dura to head and neck surgery

Cited by 7 publications

References 1 publication

Skull Base Dural Thickness and Relationship to Demographic Features: A Postmortem Study and Literature Review

Skull Base Dural Thickness and Relationship to Demographic Features: A Postmortem Study and Literature Review

A Simple Technique for Bridging Small Cranial Dural Defects Without the Use of Grafts: Technical Note

Severe pneumocranium after gamma knife stereotactic radiosurgery for brain metastasis: A case report and literature review

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