title: Fascia patchwork closure for endoscopic endonasal skull base surgery.
abstract: With the development of endoscopic technology and surgery, resection of midline skull base tumors has been achieved using endoscopic endonasal skull base (EESB) approaches. EESB approaches reportedly have a greater risk of postoperative cerebrospinal fluid (CSF) leakage. Recently, the introduction of the nasoseptal flap (NSF) decreased dramatically the incidence of CSF leakage, but the use of an NSF increases the risk of disturbing the function of the nose. Here, we report our new technique called "fascia patchwork closure" for closure after EESB surgery and its outcome. All 48 cases involved midline skull base tumors resected via EESB approaches. Of them, 32 cases were closed by the fascia patchwork technique after tumor resection, and there was no incidence of CSF leakage. Moreover, 6 of the 32 cases were closed without the use of an NSF, indicating that the fascia patchwork closure approach is effective as part of a multilayer closure for the prevention of CSF leakage. The establishment and popularization of this technique might result in the further development of EESB surgery and also an improvement of postoperative nasal function.
authors: Department of Neurosurgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8605, Japan, yudo@nms.ac.jp.
authors: Yudo
authors: Y
authors: Ishii
authors: Shigeyuki
authors: S
authors: Tahara
authors: Yujiro
authors: Y
authors: Hattori
authors: Akira
authors: A
authors: Teramoto
authors: Akio
authors: A
authors: Morita
authors: Akira
authors: A
authors: Matsuno
mesh_terms: D065634:Cerebrospinal Fluid Leak / Q000453:epidemiology / Q000209:etiology; D002983:Clinical Competence; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D009296:Nasal Cavity / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D019291:Skull Base / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D058106:Wound Closure Techniques