Mass Effect Due to Hypertrophic Pericranial Flap in the Reconstruction of Dural Defect

Velasco-Torres, Héctor Sebastián; Amador, Juan Luis Gómez; Feinholz, Samuel Romano

doi:10.1016/j.wneu.2015.07.070

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…These sites mean additional, albeit limited resections for the donor tissue. [33,34]. Viable tissue near the incision site represents another source of autografts, as demonstrated in our study.…”

Section: Discussionsupporting

confidence: 60%

“…Although grafts from viable tissues are very efficient in surgical reconstructions, their use is not without limitations and risks. This is especially true for large tissue grafts, as their harvesting may contribute to longer operative time and associated higher infection rate, postoperative complications at the donor site, longer recovery, or may lead to plastic reconstruction [33,36,40]. In our study, the grafts were up to 4 cm 2 in size and were obtained directly from the flaps formed during the operation, so we did not experience difficulties during the operation or in the recovery period.…”

Section: Discussionmentioning

confidence: 94%

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Soft tissue grafts for dural reconstruction after meningioma surgery

Velnar

Gradišnik

2019

Bosn J of Basic Med Sci

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The meninges are involved in various pathologies and are often directly or indirectly severed during surgical procedures, especially the dura mater. This can pose a real challenge for the surgeon, as a proper reconstruction of the meninges is important to prevent complications such as cerebrospinal fluid leak (CSF). A variety of techniques for dural reconstruction have been described, employing natural and artificial materials. A novel technique for dural reconstruction involves soft tissue grafts in the form of fibrous or fibromuscular flaps, which are placed on the dural defects to seal the gaps. These soft tissue grafts represent an appropriate scaffold for cell ingrowth and fibrosis, thus preventing CSF. In this pilot study, we described the application of soft tissue grafts for dural reconstruction in 10 patients who underwent convexity meningioma surgery.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 94%

Soft tissue grafts for dural reconstruction after meningioma surgery

Velnar

Gradišnik

2019

Bosn J of Basic Med Sci

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“…Excessive torsion of the pedicle may also compromise its survival. 17 There are different techniques defined for transfrontal transfer of the flap. 8,18,19 The size of the opening should be at least 10 Â 15 mm.…”

Section: Discussionmentioning

confidence: 99%

Clinical Experience with Secondary Endoscopic Reconstruction of Clival Defects with Extracranial Pericranial Flaps

et al. 2018

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Objectives The aim of this study is to report the clinical outcome of extracranial pericranial flaps (ePCF) used for reconstruction of clival dural defects following failure of primary repair. Design Retrospective review of skull base database. Setting Academic medical center. Participants Patients undergoing reconstruction of clival defects with ePCF following endoscopic endonasal surgery (EES). Main outcome measures Postoperative cerebrospinal fluid (CSF) leak, meningitis, and flap necrosis. Results Seven patients (five males and two females) who underwent ePCF reconstruction for clival defects following EES were included. All patients (ages 8–64 years) had a postoperative CSF leak due to a failed primary clival reconstruction (five had one, one had two, and one had three failed CSF leak repairs prior to ePCF reconstruction). Nasoseptal and inferior turbinate (lateral nasal wall) flaps were not available for secondary reconstruction due to prior surgeries. The immediate success rate of ePCF for the reconstruction of clival defects in patients with multiple flap failures was 58%. Two patients developed CSF leaks that were successfully repaired endoscopically with the addition of free tissue grafts; one patient had partial flap necrosis that required debridement; none required an additional vascularized flap. Width of the defect, length of the defect, properties of the ePCF, and age did not demonstrate significance (p > 0.05) for adverse outcome. Conclusion An ePCF is a reconstructive option for high-risk, large clival defects when other local and regional vascularized flaps are not available or fail. ePCFs can be used for reconstruction of clival defects in all populations, including pediatric patients.

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“…[1][2][3] However, dural repair and reconstruction after major operations remain a challenge for neurosurgeons. 4,5 It is well known that intact dura matters cover the brain surface and function as a natural barrier to prevent cerebrospinal fluid (CSF) leakage. Postoperative CSF leakage is a life-threatening complication that can lead to various consequences, such as meningeal pseudocyst and arachnoiditis.…”

Section: Introductionmentioning

confidence: 99%

In situ precise electrospinning of medical glue fibers as nonsuture dural repair with high sealing capability and flexibility

Lv¹,

Dong²,

Li³

et al. 2016

IJN

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Purpose In this work, we propose an in situ precise electrospinning of medical glue fibers onto dural wound for improving sealing capability, avoiding tissue adhesion, and saving time in dural repair. Methods N -octyl-2-cyanoacrylate, a commercial tissue adhesive (medical glue), can be electrospun into ultrathin fibrous film with precise and homogeneous deposition by a gas-assisted electrospinning device. Results The self-assembled N -octyl-2-cyanoacrylate film shows high compactness and flexibility owing to its fibrous structure. Simulation experiments on egg membranes and goat meninges demonstrated that this technology can repair small membrane defects quickly and efficiently. Conclusion This method may have potential application in dural repair, for example, working as an effective supplementary technique for conventional dura suture.

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Mass Effect Due to Hypertrophic Pericranial Flap in the Reconstruction of Dural Defect

Cited by 5 publications

References 9 publications

Soft tissue grafts for dural reconstruction after meningioma surgery

Soft tissue grafts for dural reconstruction after meningioma surgery

Clinical Experience with Secondary Endoscopic Reconstruction of Clival Defects with Extracranial Pericranial Flaps

In situ precise electrospinning of medical glue fibers as nonsuture dural repair with high sealing capability and flexibility

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