Abstract
Background:
Endoscopic repair of large skull base defects following endoscopic anterior skull base resection using free grafts or pedicled vascular flaps in a single or multilayer technique have been well described.
Objective:
The purpose of this study is to review our experience in endoscopic reconstruction of large anterior skull base defects following endoscopic anterior skull base resection using a single layer of acellular dermal allograft.
Study Design:
This study is retrospective chart review at a tertiary medical center from 1996 to 2014.
Materials and Methods:
Of 69 patients, 46 patients met these criteria. All repair of skull base defects were performed by a transnasal, endoscopic approach using a single layer of acellular dermal allograft. The main outcome measured was the success of graft take. Comparison with the group reconstructed using different techniques was performed.
Results:
Mean patient age was 58 years. Of the 69 patients, 17 patients underwent endoscopic hemi skull base resection and 29 patients underwent endoscopic total skull base resection. The most common tumor was olfactory neuroblastoma. Three patients (6.5%) had postoperative cerebrospinal fluid leak. Of these three patients, two were repaired using a second layer of acellular dermal allograft and one patient using a nasoseptal flap. Two patients had a lumbar drain placed.
Six patients underwent reconstruction in a different bilayer technique using acellular dermal allograft and either a nasoseptal flap or an on-lay free mucosal graft. None of these patients had postoperative cerebrospinal leak.
Conclusion:
Single layer acellular dermal allograft can be used successfully to reconstruct large defects following endoscopic anterior skull base resection.