title: Banked Fascia Lata in Sellar Dura Reconstruction after Endoscopic Transsphenoidal Skull Base Surgery.
abstract: Objectives Cerebrospinal fluid (CSF) leakage is an undesirable complication of transsphenoidal skull base surgery. The issue of the most appropriate sellar dura repair remains unresolved, although a multilayer technique using autologous fascia lata is widely used. We describe the novel application of a homologous banked fascia lata graft as an alternative to an autologous one in the reconstruction of sellar dura defects in endoscopic transsphenoidal surgery. Design The clinical records of patients who underwent endoscopic transsphenoidal surgery at our department from June 2012, when we started using homologous fascia lata, up to July 2014 were reviewed retrospectively. The data concerning diagnosis, reconstruction technique, and surgical outcome were analyzed. Results We treated 16 patients successfully with banked fascia lata. Twelve patients presented intraoperative CSF leakage, and four patients were treated for postoperative rhinoliquorrhea. Banked fascia lata was used in a single-to-multilayer technique, depending on the anatomical features of the defect and of the sellar floor. No complications or failures in sella reconstruction occurred. Conclusion A banked fascia lata graft proved reliable and safe in providing an effective sellar dura reconstruction. Used in a multilayer strategy, it should be considered a viable alternative to an autologous fascia lata graft.
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, Padova University, Treviso, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fiorindi
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, Padova University, Treviso, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gioffrè
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, Padova University, Treviso, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Boaro
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, Padova University, Treviso, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Billeci
authors.affiliation: ENT Division, Treviso Regional Hospital, Padova University, Treviso, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Frascaroli
authors.affiliation: ENT Division, Treviso Regional Hospital, Padova University, Treviso, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Sonego
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital, Padova University, Treviso, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Longatti
keywords: cerebrospinal fluid leak; endoscopic transsphenoidal surgery; fascia lata; sellar dura reconstruction; tissue bank