Overlapping free bone graft with galea-pericranium in reconstruction of the anterior skull base to prevent CSF leak and sequestrum formation.
Background. Reconstruction of the skull base after resection of a tumour is important to prevent postoperative complications such as infectionsand cerebrospinal fluid (CSF) leakage. Several reconstructive methods of the anterior skull base have been reported but, their long-term results are not clear. Methods. We describe a technique used after removal of an olfactory neuroblastoma with infiltration of the skull base. The reconstructed dura was covered with a galeal patch, a replicated galeal-pericranial flap, a graft from the inner table of skull, and a vascularised galeal-pericranial flap placed on the skull base defect. All layers were fixed with fibrin glue. Conclusion. Three dimensional computed tomography (3D-CT) at bone window settings demonstrated the bone graft covered the bone defect and was not absorbed and after 11 years there have been no signs of tumour regrowth or complications.
Abe
T
T
Department of Neurosurgery, Oita University School of Medicine, Idaigaoka, Hasama, Yufu, Oita, Japan.
Goda
M
M
Kamida
T
T
Fujiki
M
M
Kobayashi
H
H
Nakano
T
T
Mori
T
T
Watanabe
T
T
Suzuki
M
M
D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D002558:Cerebrospinal Fluid Otorrhea / Q000175:diagnosis / Q000517:prevention & control*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000517:prevention & control*; D035262:Cranial Fossa, Anterior / Q000473:pathology / Q000601:surgery*; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage; D018305:Ganglioneuroblastoma / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control*; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed
D015718:Fibrin Tissue Adhesive