Microplate-bridge technique for watertight dural closures in the combined petrosal approach.

Abstract:

BACKGROUND:Although the combined petrosal approach has significant advantages for medium to large petroclival lesions, it carries the risk of a few major complications. The cerebrospinal fluid leak rate with this approach has been reported to be as high as 15%. OBJECTIVE:To describe an innovative technique of watertight dural closure with a long microplate-bridge technique for the combined petrosal approach. METHODS:We describe our method of watertight dural closures with the microplate-bridge technique for combined petrosal approaches using cadaveric heads and clinical cases. We review our postoperative outcomes in respect to cerebrospinal fluid leaks. RESULTS:The technique involves a fascial graft to the presigmoid-subtemporal defect, fixated with a long microtitanium plate over the cranial base side. The fascial graft is augmented by covering it with an abdominal fat graft and a vascularized pericranial flap. This technique was performed in 23 patients after surgical resection of petroclival meningiomas with only 1 postoperative cerebrospinal fluid leak (4.4%). CONCLUSION:We recommend this safe and simple closure technique during skull base surgery.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Kusumi M,Fukushima T,Aliabadi H,Mehta AI,Noro S,Rosen CL,Fujii K

doi

10.1227/NEU.0b013e3182356269

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

264-9

issue

2 Suppl Operative

eissn

0148-396X

issn

1524-4040

journal_volume

70

pub_type

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