Volume 29, Issue 3
DOI: 10.24205/03276716.2020.913
Application of Dural Suture Technique in Transnasal Endoscopic Skull Base Surgery
Abstract
Objective: To investigate the effectiveness of dural suture in the prevention of cerebrospinal fluid leakage during endoscopic transnasal skull base surgery.
Methods: a total of 162 patients undergoing endoscopic skull base surgery in our hospital were collected. According to the degree of cerebrospinal fluid leakage, they were divided into four grades: no obvious cerebrospinal fluid leakage in grade 0, small flow cerebrospinal fluid leakage in Grade 1, medium flow cerebrospinal fluid leakage in grade 2 and significant cerebrospinal fluid leakage in grade 3.The patients with grade 1 and 2 cerebrospinal fluid leakage were simply sutured with sellar base dura for skull base reconstruction, while patients with grade 3 cerebrospinal fluid leakage were treated with suturing dura mater and fascia lata and covering nasal septum mucosal flap.
Results: among 162 cases, 108 cases (66.6%) had cerebrospinal fluid leakage during operation. According to the grade of cerebrospinal fluid leakage, 54 cases were grade 0, 40 cases were grade 1, 35 cases were grade 2 and 33 cases were grade 3. In 108 cases of intraoperative cerebrospinal fluid leakage, suturing technique was used to repair the cerebrospinal fluid leakage. Two cases (1.85%) were found to have cerebrospinal fluid leakage after operation, which belonged to grade 3 cerebrospinal fluid leakage patients. Conclusion: dural suture is a simple and effective method for skull base reconstruction in endoscopic transnasal skull base surgery.
Keywords
skull base tumor neuroendoscopy; cerebrospinal fluid leakage; skull base reconstruction