title: Augmented autologous pericranium duraplasty in 100 posterior fossa surgeries--a retrospective case series.
abstract: BACKGROUND
  Primary closure of the dura in posterior fossa (p-fossa) surgeries is technically difficult and usually requires the use of a dural substitute. A variety of substitutes are currently available and data suggest that autologous materials are preferred in comparison with nonautologous substitutes.
  
  
  OBJECTIVE
  To report our experience using locally harvested autologous pericranium as a dural substitute in patients who underwent p-fossa surgeries.
  
  
  METHODS
  Retrospective analysis of patients who had undergone p-fossa craniotomies between 2005 and 2011. All patients received locally harvested autologous pericranium for duraplasty augmented with a dural sealant. Data were reviewed for complications including: surgical site infection, meningitis, cerebrospinal fluid leak, the radiographic formation of a pseudomeningocele, and any new neurological symptoms related to the incision or repair.
  
  
  RESULTS
  One hundred patients were identified. Indications for surgery included tumor, vascular lesions, or hemorrhage requiring surgical intervention, symptomatic Chiari I malformation, microvascular decompression for trigeminal neuralgia, and trauma requiring surgical decompression. The complication rate was 1% with 1 patient developing an nonsteroidal anti-inflammatory drug-induced aseptic meningitis and graft dehiscence requiring surgical revision.
  
  
  CONCLUSIONS
  Autologous pericranium with dural sealant augmentation is an effective way to repair the durotomy in p-fossa surgeries. To the best of our knowledge, this is currently the largest study using this technique in the adult neurosurgical literature. Our results report a much lower rate of complications in comparison with other duraplasty studies.
authors: Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard University, 110 Francis St, Boston, MA 01125, USA.
authors: Fred C
authors: FC
authors: Lam
authors: Ekkehard
authors: E
authors: Kasper
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014182:Transplantation, Autologous