Anterior Skull Reconstruction: Does Fat Preparation Matter?
Background: Anterior skull base defects are a part of many surgical approaches to neoplasms, inflammatory diseases and trauma of this part of the anatomy. CSF rhinorrhea may result from trauma, surgery, or rupture of preexisting defect in the skull base. Many materials have been used to reconstruct...
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Format: | Tagungsbericht |
Sprache: | eng |
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Zusammenfassung: | Background:
Anterior skull base defects are a part of many surgical approaches to neoplasms, inflammatory diseases and trauma of this part of the anatomy. CSF rhinorrhea may result from trauma, surgery, or rupture of preexisting defect in the skull base. Many materials have been used to reconstruct skull base defects, but the most universal material, whether by itself or in combination with other tissue, is subcutaneous fat. It has not been validated whether the fat needs any special preparation before implantation. Establishing whether unprepared fat is equally effective as specially prepared fat may result in quicker surgical times and the need to harvest a smaller volume of fat, both leading to better patient outcomes. We sought to determine if dried and compressed fat leads to better surgical success rates.
Methods:
After approval from our institution's IACUC, we created anterior skull base defects in 28 Sprague Dawley rats based on a previously validated model. Reconstruction was then done in three arms: skin closure only, native fat sealed with fibrin glue, and specially prepared fat sealed with fibrin glue. The preparation of the fat included drying and compressing the native fat. After 2 weeks of healing time, fluorescein was injected into the subarachnoid space through a burr hole and allowed to circulate while the animal was under anesthesia. The animals were then euthanized, and the nasal bones were removed. The persistent CSF leak was determined by the presence of fluoresce on the nasal mucosa.
Results:
The control group had a CSF leak rate of 67% (
n
= 9), the native fat group had a 44% leak rate (
n
= 9), and those with prepared fat had a 30% leak rate (
n
= 10). Chi-squared analysis showed that these differences were not statistically significant. The
p
value between the control and prepared fat groups was
p |
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ISSN: | 2193-6331 2193-634X |
DOI: | 10.1055/s-0035-1546502 |