Simplified Dural Reconstruction Procedure Using Biocompatible Polyglycolic Acid Felt with Autologous Abdominal Fat Grafts after a Transpetrosal Approach

Yamaguchi, Shigeru; Terasaka, Shunsuke; Okamoto, Michinari; Ishi, Yukitomo; Motegi, Hiroaki; Kobayashi, Hiroyuki; Houkin, Kiyohiro

Simplified Dural Reconstruction Procedure Using Biocompatible Polyglycolic Acid Felt with Autologous Abdominal Fat Grafts after a Transpetrosal Approach

Yamaguchi, Shigeru; Terasaka, Shunsuke; Okamoto, Michinari et al.

World neurosurgery, 2019, 132, E710-E715

Permalink : https://hdl.handle.net/2115/79851

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アクセス権	open access
URI	https://hdl.handle.net/2115/79851
タイトル	Simplified Dural Reconstruction Procedure Using Biocompatible Polyglycolic Acid Felt with Autologous Abdominal Fat Grafts after a Transpetrosal Approach
著者	Yamaguchi, Shigeru ; Terasaka, Shunsuke ; Okamoto, Michinari ; Ishi, Yukitomo ; Motegi, Hiroaki ; Kobayashi, Hiroyuki ; Houkin, Kiyohiro
著者名 Yamaguchi, Shigeru
e-Rad_Researcher 10447055 著者名 Terasaka, Shunsuke
著者名 Okamoto, Michinari
著者名 Ishi, Yukitomo
著者名 Motegi, Hiroaki
e-Rad_Researcher 70374478 著者名 Kobayashi, Hiroyuki
e-Rad_Researcher 90229146 著者名 Houkin, Kiyohiro
言語	英語
キーワード	Cerebrospinal fluid leakage
	Dural reconstruction
	Petrosal approach
	Polyglycolic acid felt
	Skull base surgery
発行日	2019-12
出版者	Elsevier
収録物名	World neurosurgery
巻(号)	132
ページ	E710-E715
抄録	BACKGROUND: Dural reconstruction after transpetrosal approaches is complicated because complete primary closure of presigmoid dura mater is difficult to achieve. To address this problem, we use biocompatible polyglycolic acid (PGA) felt (Durawave) to reconstruct dural defects. To evaluate the use of PGA felt in dural reconstruction, we compared these results with those after conventional duraplasty using autologous fascia grafts. METHODS: We retrospectively surveyed all cases involving a transpetrosal approach reported since 2013. In the conventional procedure, autologous fascia was fixed over the dural defect using stay sutures; any remaining dead space was obliterated by placing abdominal fat grafts. Since April 2017, we have used PGA felt instead of fascia. RESULTS: Of the 37 cases identified, 27 were reconstructed according to the conventional procedure, and the remaining 10 cases were reconstructed using PGA felt. Among the 27 conventional cases, 8 involved cerebrospinal fluid (CSF)-related complications, including 3 cases of rhinorrhea and 5 cases of subcutaneous fluid collection, and 2 cases (7%) required repair surgery. Of the 10 cases involving PGA felt, 1 case (10%) involved subcutaneous fluid collection and required repair surgery, and whereas the remaining 9 cases had no evidence of CSF leakage. In addition, the median dural reconstruction time using PGA felt was 9 minutes, significantly shorter than that when autologous fascia was used (median, 44 minutes). CONCLUSIONS: Using PGA felt for presigmoid dura simplifies dural reconstruction because it obviates the need to suture in a deep field. PGA felt has the potential to prevent CSF-related complications after transpetrosal approaches.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報	© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
PISSN	1878-8750
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.wneu.2019.08.033