title: Anterior Skull Base Defects Reconstructed Using Three-Layer Method: 78 Consecutive Cases with Long-Term Follow-Up.
abstract: ObjectivesAnterior skull base defects are potentially lethal and surgical treatment must be performed as soon as possible. The purpose of this study was to evaluate whether our technique is effective or not in long-term period.DesignRetrospective chart review of all patients whose data were entered into the Hospital Registry System between 1995 and 2015.Setting/ParticipantsThis study was performed at the Gaziantep University School of Medicine, Gaziantep, Turkey, in 2015 and included 78 patients who in the past 20 years underwent three-layer reconstruction surgery for anterior skull base defects at the same university.Main Outcome MeasuresAmong the patients, defects repaired by transcranial approach had the lowest recurrence rate. Overall, successful repair was achieved in 100% of the patients.ResultsPure transbasal approach was used as a single procedure on 71 (91%) patients. Combined approaches were used in seven (9%) cases. The extended transbasal approach was combined with a transfacial approach in four patients and with a pterional approach in three patients.ConclusionWe encourage the use of three-layer reconstruction and recommend free fascia lata grafts and galeal flaps with vascularized pedicle as sealing material of choice in all types of cases such as tumor and trauma.
authors.affiliation: Department of Neurosurgery, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Geyik
authors.affiliation: Department of Neurosurgery, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Erkutlu
authors.affiliation: Department of Neurosurgery, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Alptekin
authors.affiliation: Department of Neurosurgery, Kafkas University School of Medicine, Kars, Turkey.
authors.forename: Inan
authors.initials: I
authors.lastname: Gezgin
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Mizrak
authors.affiliation: Department of Emergency Medicine, EBN School of Medicine, Zirve University, Gaziantep, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dokur
authors.affiliation: Department of Neurosurgery, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Abdulvahap
authors.initials: A
authors.lastname: Gok
keywords: pericranium; reconstruction; skull base defect; vascular flap