Posterior fossa duraplasty in children: remarks on surgery and clinical and CT follow-up

Parízek, J; Šercl, M; Michl, A; Měřička, Pavel; Němeček, S.; Nĕmecková, J; Jakubec, J.

doi:10.1007/bf00303609

Cited by 19 publications

(12 citation statements)

References 4 publications

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“…Xenogeneic grafts (No. 881) were prepared from the bovine endothoracic fascia, and bovine or ovine pericardia [25,[29][30][31]34].…”

Section: Methodsmentioning

confidence: 99%

“…5). Computed tomography (CT) proved to be a suitable method for the demonstration of dural grafts at the sites of craniectomies [31] (Fig. 6).…”

Section: Histologymentioning

confidence: 99%

“…Some detailed descriptions of the graft preparation and healing, including histology and electron microscopy was published in our previous papers [25,. Advanced imaging methods were very useful in the postoperative evaluation of postcraniectomy sites in order to investigate the healing of various kinds of DCTG [29,31]. The location, defects of sutures, CSF fistulas, dynamic motion of the graft, and/or irregular septations in the pseudomeningocele due to infection, can be diagnosed by ultrasonography (USG) [29] (Fig.…”

Section: Histologymentioning

confidence: 99%

“…Meticulous aseptic surgical technique and manipulation of the graft, and sutures of patches performed with atraumatic No. 4-0 or 5-0 suture materials (especially for continuous sutures in posterior fossa duraplasty using pericardium and dura mater) seemed necessary to prevent infections [28,30,31].…”

Section: Surgical Implantation Of the Graftsmentioning

confidence: 99%

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Detailed evaluation of 2959 allogeneic and xenogeneic dense connective tissue grafts (fascia lata, pericardium, and dura mater) used in the course of 20 years for duraplasty in neurosurgery

et al. 1997

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Surgical experience with 2959 allogeneic and xenogeneic dense connective tissue grafts (1767 of fascia lata, 909 of pericardium, and 283 of dura mater), used in 2665 neurosurgical operations performed in the course of 20 years (1976 to 1995) is reported. Duraplasty using either allogeneic or xenogeneic grafts has had a similar, and favourable clinical outcome. Nevertheless, the pliable deep frozen fascia lata grafts, which could be used in any location, have been reserved for sella turcica plugging, anterior cranial base plasty, aneurysmal wrapping, and surgery of lipomyelomeningocele. Pericardium and dura mater grafts were in the majority of cases used over the brain convexity and posterior cranial fossa. Ovine pericardium proved to be superior to bovine and allogeneic pericardia because of its workability, flexibility, reduced thickness, and better transparency. Postsurgical complications occurred in 7.3%, and they were: 1) cerebrospinal fluid fistulas in 2.8%; 2) meningites in 2.3% (aseptic 1.4%, bacterial 0.8%, and tumoural 0.1% meningites); 3) pseudomeningoceles in 2.2%; 4) wound infections in 0.6%; 5) malresorptive hydrocephalus in 0.5%; and 6) adhesions to nerve tissue in 0.5%. The majority of complications healed without surgery. Forty-eight grafts (1.6%) failed to fulfil the requirements of the surgeon, and 46 of them were re-operated upon. Though another thirty-nine grafts healed successfully, 39 shunts (1.5%) had to be performed for malresorptive hydrocephalus (0.9%), and/or for a big pseudomeningocele (0.6%). So, the pure complication rate in 2665 duraplasties was 3.1%. The complex evaluation of the allogeneic and xenogeneic grafts (fascia, pericardium, and dura mater), used for duraplasty in neurosurgery during the last 20 years proved them, as remarkably good, with a success rates of 96.9%.

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“…Xenogeneic grafts (No. 881) were prepared from the bovine endothoracic fascia, and bovine or ovine pericardia [25,[29][30][31]34].…”

Section: Methodsmentioning

confidence: 99%

“…5). Computed tomography (CT) proved to be a suitable method for the demonstration of dural grafts at the sites of craniectomies [31] (Fig. 6).…”

Section: Histologymentioning

confidence: 99%

Section: Histologymentioning

confidence: 99%

Section: Surgical Implantation Of the Graftsmentioning

confidence: 99%

See 2 more Smart Citations

Detailed evaluation of 2959 allogeneic and xenogeneic dense connective tissue grafts (fascia lata, pericardium, and dura mater) used in the course of 20 years for duraplasty in neurosurgery

et al. 1997

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“…Approximately 30% of children with posterior fossa tumors exhibit hydrocephalus and pseudomeningocele after tumor resection, requiring ventricular or lumbarperitoneal CSF shunting [4,5] . Despite some papers suggesting the use of dural grafts plus fibrin glue to better seal the craniotomy, the problem of pseudomeningocele still remains [6] .…”

Section: Discussionmentioning

confidence: 99%

Metastatic Spread Outside the Central Nervous System of Anaplastic Medulloblastoma Associated with a Spinal-Peritoneal Shunt Immediately after Radiotherapy

Sardi¹,

Paolicchi²,

Buccoliero

et al. 2011

Pediatr Neurosurg

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Duraplasty with freeze-dried cadaveric dura versus occipital pericranium for Chiari type I malformation: Comparative study

Vanaclocha

Saiz-Sapena

1997

Acta neurochir

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During the period from October 1, 1989 to October 1, 1995 a total of 26 cases of Chiari type I malformation not associated with syringomyelia were attended in our Hospital. All patients underwent cranio-cervical decompression, with occipital craniectomy and removal of the posterior arch of C1. In 3/26 (11.5%) cases an additional C2 laminectomy had to be performed and in 1/26 (3.8%) case the C3 laminae were also removed. A first group of 13 patients underwent dural repair with freeze-dried cadaveric dura sutured with continuous 4-0 Vicryl running stitches, reinforced with fibrin sealant (Tissucol). A second group of 13 patients underwent duraplasty with autogenous occipital pericranium also sutured with continuous 4-0 Vycril but no fibrin sealant at all was added. In the first group, in which freeze-dried cadaveric dura plus Tissucol was used, there were 2/13 (15.3%) cases of CSF leak, requiring some additional skin stitches to stop the leak. In 5/13 (38.4%) cases there were notorious subcutaneous CSF accumulations that required repeated punctures plus compressive bandage. In 6/13 (46.1%) pseudomeningoceles appeared that took a year to clear completely. In the 13 patients who underwent dural repair with autogenous occipital pericranium watertight closure was achieved with sutures only, no fibrin sealant was added at all. Neither CSF leaks through the wound nor subcutaneous CSF accumulations were noted. We conclude that, in our hands, autologous pericranium taken from the occipital area, gives better results than freeze-dried cadaveric dura mater in duraplasty for surgical repair of Chiari type I malformation.

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Posterior fossa duraplasty in children: remarks on surgery and clinical and CT follow-up

Cited by 19 publications

References 4 publications

Detailed evaluation of 2959 allogeneic and xenogeneic dense connective tissue grafts (fascia lata, pericardium, and dura mater) used in the course of 20 years for duraplasty in neurosurgery

Detailed evaluation of 2959 allogeneic and xenogeneic dense connective tissue grafts (fascia lata, pericardium, and dura mater) used in the course of 20 years for duraplasty in neurosurgery

Metastatic Spread Outside the Central Nervous System of Anaplastic Medulloblastoma Associated with a Spinal-Peritoneal Shunt Immediately after Radiotherapy

Duraplasty with freeze-dried cadaveric dura versus occipital pericranium for Chiari type I malformation: Comparative study

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