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Collagen matrix as an inlay in endoscopic skull base reconstruction

Published online by Cambridge University Press:  18 July 2017

G M Oakley ,
J M Christensen ,
M Winder ,
B P Jonker ,
A Davidson ,
T Steel ,
C Teo  and
R J Harvey
G M Oakley*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, USA Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia
J M Christensen
Affiliation:
Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia
M Winder
Affiliation:
Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia Department of Neurosurgery, St Vincent's Hospital, Sydney, Australia
B P Jonker
Affiliation:
Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia Department of Neurosurgery, St Vincent's Hospital, Sydney, Australia
A Davidson
Affiliation:
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
T Steel
Affiliation:
Department of Neurosurgery, St Vincent's Hospital, Sydney, Australia
C Teo
Affiliation:
Centre for Minimally Invasive Neurosurgery, Prince of Wales Hospital, Sydney, Australia
R J Harvey
Affiliation:
Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
*
Address for correspondence: Dr Gretchen M Oakley, 2233 Post St, 3rd Floor, Box 1225, San Francisco, CA 94117, USA Fax: +1 415 885 7546 E-mail: gmoakley@gmail.com
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Abstract

Background:

Multi-layer reconstruction has become standard in endoscopic skull base surgery. The inlay component used can vary among autografts, allografts, xenografts and synthetics, primarily based on surgeon preference. The short- and long-term outcomes of collagen matrix in skull base reconstruction are described.

Methods:

A case series of patients who underwent endoscopic skull base reconstruction with collagen matrix inlay were assessed. Immediate peri-operative outcomes (cerebrospinal fluid leak, meningitis, ventriculitis, intracranial bleeding, epistaxis, seizures) and delayed complications (delayed healing, meningoencephalocele, prolapse of reconstruction, delayed cerebrospinal fluid leak, ascending meningitis) were examined.

Results:

Of 120 patients (51.0 ± 17.5 years, 41.7 per cent female), peri-operative complications totalled 12.7 per cent (cerebrospinal fluid leak, 3.3 per cent; meningitis, 3.3 per cent; other intracranial infections, 2.5 per cent; intracranial bleeding, 1.7 per cent; epistaxis, 1.7 per cent; and seizures, 0 per cent). Delayed complications did not occur in any patients.

Conclusion:

Collagen matrix is an effective inlay material. It provides robust long-term separation between sinus and cranial cavities, and avoids donor site morbidity, but carries additional cost.

Keywords

Endoscopic SurgerySkull BaseCollagen
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 3 , March 2018 , pp. 214 - 223
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented as a poster at the Australian Society of Otolaryngology Head and Neck Surgery Annual Scientific Meeting, 6–8 March 2016, Melbourne, Victoria, Australia.

References

1 Harvey, RJ, Smith, JE, Wise, SK, Patel, SJ, Frankel, BM, Schlosser, RJ. Intracranial complications before and after endoscopic skull base reconstruction. Am J Rhinol 2008;22:516–21CrossRefGoogle ScholarPubMed
2 Bernal-Sprekelsen, M, Rioja, E, Ensenat, J, Enriquez, K, Viscovich, L, Agredo-Lemos, FE et al. Management of anterior skull base defect depending on its size and location. Biomed Res Int 2014;2014:346873 Google Scholar
3 Bhavana, K, Kumar, R, Keshri, A, Aggarwal, S. Minimally invasive technique for repairing CSF leaks due to defects of posterior table of frontal sinus. J Neurol Surg B Skull Base 2014;75:183–6Google ScholarPubMed
4 Farooq, MU, Ansari, MA. Cerebrospinal fluid rhinorrhea: etiology, site of leakage and endoscopic management. J Coll Physicians Surg Pak 2011;21:460–3Google Scholar
5 Kong, DS, Kim, HY, Kim, SH, Min, JY, Nam, DH, Park, K et al. Challenging reconstructive techniques for skull base defect following endoscopic endonasal approaches. Acta Neurochir (Wien) 2011;153:807–13Google Scholar
6 Sanders-Taylor, C, Anaizi, A, Kosty, J, Zimmer, LA, Theodosopoulos, PV. Sellar reconstruction and rates of delayed cerebrospinal fluid leak after endoscopic pituitary surgery. J Neurol Surg B Skull Base 2015;76:281–5Google Scholar
7 Amit, M, Margalit, N, Abergel, A, Gil, Z. Fascia lata for endoscopic reconstruction of high-flow leaks: the champagne cork technique. Otolaryngol Head Neck Surg 2013;148:697–700 CrossRefGoogle ScholarPubMed
8 Luginbuhl, AJ, Campbell, PG, Evans, J, Rosen, M. Endoscopic repair of high-flow cranial base defects using a bilayer button. Laryngoscope 2010;120:876–80CrossRefGoogle ScholarPubMed
9 Ozturk, O, Polat, S, Uneri, C. Endoscopic endonasal management of cerebrospinal fluid rhinorrhea. J Craniofac Surg 2012;23:1087–92CrossRefGoogle ScholarPubMed
10 Villaret, AB, Yakirevitch, A, Bizzoni, A, Bosio, R, Bignami, M, Pistochini, A et al. Endoscopic transnasal craniectomy in the management of selected sinonasal malignancies. Am J Rhinol Allergy 2010;24:60–5Google Scholar
11 Emanuelli, E, Milanese, L, Rossetto, M, Cazzador, D, d'Avella, E, Volo, T et al. The endoscopic endonasal approach for cerebrospinal fluid leak repair in the elderly. Clin Neurol Neurosurg 2015;132:21–5CrossRefGoogle ScholarPubMed
12 Germani, RM, Vivero, R, Herzallah, IR, Casiano, RR. Endoscopic reconstruction of large anterior skull base defects using acellular dermal allograft. Am J Rhinol 2007;21:615–18CrossRefGoogle ScholarPubMed
13 Eloy, JA, Patel, SK, Shukla, PA, Smith, ML, Choudhry, OJ, Liu, JK. Triple-layer reconstruction technique for large cribriform defects after endoscopic endonasal resection of anterior skull base tumors. Int Forum Allergy Rhinol 2013;3:204–11Google Scholar
14 Gaynor, BG, Benveniste, RJ, Lieberman, S, Casiano, R, Morcos, JJ. Acellular dermal allograft for sellar repair after transsphenoidal approach to pituitary adenomas. J Neurol Surg B Skull Base 2013;74:155–9Google Scholar
15 Ismail, AS, Costantino, PD, Sen, C. Transnasal transsphenoidal endoscopic repair of CSF leakage using multilayer acellular dermis. Skull Base 2007;17:125–32Google Scholar
16 Liebelt, BD, Huang, M, Baskin, DS. Sellar floor reconstruction with the Medpor implant versus autologous bone after transnasal transsphenoidal surgery: outcome in 200 consecutive patients. World Neurosurg 2015;84:240–5Google Scholar
17 Chung, SB, Nam, DH, Park, K, Kim, JH, Kong, DS. Injectable hydroxyapatite cement patch as an on-lay graft for the sellar reconstructions following endoscopic endonasal approach. Acta Neurochir (Wien) 2012;154:659–64Google Scholar
18 Harvey, RJ, Parmar, P, Sacks, R, Zanation, AM. Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence. Laryngoscope 2012;122:452–9CrossRefGoogle ScholarPubMed
19 Oakley, GM, Orlandi, RR, Woodworth, BA, Batra, PS, Alt, JA. Management of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations. Int Forum Allergy Rhinol 2016;6:17–24 Google Scholar
20 Soudry, E, Turner, JH, Nayak, JV, Hwang, PH. Endoscopic reconstruction of surgically created skull base defects: a systematic review. Otolaryngol Head Neck Surg 2014;150:730–8Google Scholar
21 Citardi, MJ, Cox, AJ 3rd, Bucholz, RD. Acellular dermal allograft for sellar reconstruction after transsphenoidal hypophysectomy. Am J Rhinol 2000;14:69–73 Google Scholar
22 Lorenz, RR, Dean, RL, Hurley, DB, Chuang, J, Citardi, MJ. Endoscopic reconstruction of anterior and middle cranial fossa defects using acellular dermal allograft. Laryngoscope 2003;113:496–501 CrossRefGoogle ScholarPubMed
23 Illing, E, Chaaban, MR, Riley, KO, Woodworth, BA. Porcine small intestine submucosal graft for endoscopic skull base reconstruction. Int Forum Allergy Rhinol 2013;3:928–32CrossRefGoogle ScholarPubMed
24 Braca, JA 3rd, Marzo, S, Prabhu, VC. Cerebrospinal fluid leakage from tegmen tympani defects repaired via the middle cranial fossa approach. J Neurol Surg B Skull Base 2013;74:103–7Google Scholar
25 Narotam, PK, Qiao, F, Nathoo, N. Collagen matrix duraplasty for posterior fossa surgery: evaluation of surgical technique in 52 adult patients. Clinical article. J Neurosurg 2009;111:380–6Google Scholar
26 Shorter, CD, Connor, DE Jr, Thakur, JD, Gardner, G, Nanda, A, Guthikonda, B. Repair of middle fossa cerebrospinal fluid leaks using a novel combination of materials: technical note. Neurosurg Focus 2012;32:E8 CrossRefGoogle ScholarPubMed
27 Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl 2012;(23):1–298 Google ScholarPubMed
28 Chatrath, P, Saleh, HA. Endoscopic repair of cerebrospinal fluid rhinorrhea using bone pate. Laryngoscope 2006;116:1050–3CrossRefGoogle ScholarPubMed
29 Zanation, AM, Carrau, RL, Snyderman, CH, McKinney, KA, Wheless, SA, Bhatki, AM et al. Nasoseptal flap takedown and reuse in revision endoscopic skull base reconstruction. Laryngoscope 2011;121:42–6Google Scholar
30 Hadad, G, Bassagasteguy, L, Carrau, RL, Mataza, JC, Kassam, A, Snyderman, CH et al. A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 2006;116:1882–6Google Scholar
31 Cavallo, LM, Messina, A, Esposito, F, de Divitiis, O, Dal Fabbro, M, de Divitiis, E et al. Skull base reconstruction in the extended endoscopic transsphenoidal approach for suprasellar lesions. J Neurosurg 2007;107:713–20Google Scholar
32 Wessell, A, Singh, A, Litvack, Z. One-piece modified gasket seal technique. J Neurol Surg B Skull Base 2013;74:305–10Google Scholar
33 Tabaee, A, Kamat, A, Shrivastava, R. Complex reconstruction of the sella using absorbable mini-plate in revision endoscopic pituitary surgery: technical note. J Neurol Surg A Cent Eur Neurosurg 2013;74:313–17Google Scholar
34 Sanna, M, Taibah, A, Russo, A, Falcioni, M, Agarwal, M. Perioperative complications in acoustic neuroma (vestibular schwannoma) surgery. Otol Neurotol 2004;25:379–86Google Scholar
35 Taha, AN, Almefty, R, Pravdenkova, S, Al-Mefty, O. Sequelae of autologous fat graft used for reconstruction in skull base surgery. World Neurosurg 2011;75:692–5Google Scholar
36 Hwang, PH, Jackler, RK. Lipoid meningitis due to aseptic necrosis of a free fat graft placed during neurotologic surgery. Laryngoscope 1996;106:1482–6Google Scholar
37 Leng, LZ, Brown, S, Anand, VK, Schwartz, TH. “Gasket-seal” watertight closure in minimal-access endoscopic cranial base surgery. Neurosurgery 2008;62(5 suppl 2):342–3Google Scholar
38 Zerris, VA, James, KS, Roberts, JB, Bell, E, Heilman, CB. Repair of the dura mater with processed collagen devices. J Biomed Mater Res B Appl Biomater 2007;83:580–8Google Scholar
39 Prickett, KK, Wise, SK, Delgaudio, JM. Choice of graft material and postoperative healing in endoscopic repair of cerebrospinal fluid leak. Arch Otolaryngol Head Neck Surg 2011;137:457–61Google Scholar
40 Walsh, E, Illing, E, Riley, KO, Cure, J, Srubiski, A, Harvey, RJ et al. Inaccurate assessments of anterior cranial base malignancy following nasoseptal flap reconstruction. J Neurol Surg B Skull Base 2015;76:385–9Google Scholar
41 Leong, JL, Citardi, MJ, Batra, PS. Reconstruction of skull base defects after minimally invasive endoscopic resection of anterior skull base neoplasms. Am J Rhinol 2006;20:476–82CrossRefGoogle ScholarPubMed
42 World Health Organization. WHO Guidelines on Tissue Infectivity Distribution in Transmissible Spongiform Encephalopathies. Geneva: WHO, 2006 Google Scholar
43 Warren, WL, Medary, MB, Dureza, CD, Bellotte, JB, Flannagan, PP, Oh, MY et al. Dural repair using acellular human dermis: experience with 200 cases: technique assessment. Neurosurgery 2000;46:1391–6Google Scholar