IngentaConnect Long-term endonasal endoscopic review of successful duraplasty af...

Abstract:

Background: This study was performed to examine the long-term endonasal endoscopic morphological appearance of successful duraplasty after endoscopic skull base surgery for different pathology.

Methods: This study included 65 patients who underwent endonasal endoscopic surgery for different skull base lesions with successful duraplasty. Forty patients had pituitary adenomas, 25 with macroadenomas and 15 with microadenomas. Twenty patients with cerebrospinal fluid rhinorrhea of different etiologies and three patients with meningoencephalocele were included. There were two patients with skull base meningiomas, 1 with an extensive greater wing meningioma reaching the nasal cavity and the 1 with recurrent olfactory groove meningioma. Different types of autologous materials were used in reconstructing the skull base defect. Clinical follow-up with endoscopic nasal examination was done routinely 1, 3, 6, and 12 months after surgery. CT and MRI were performed when indicated. The follow-up period ranged from 6 months to 8 years.

Results: Starting from 3 months after surgery to the rest of the follow-up period, endonasal endoscopic view of the site of duraplasty showed that with small skull base defect (<5 mm), there was neither dural pulsation nor prolapse. With moderate-size defect (5-10 mm) there was dural pulsation without prolapse. With larger defect (>10 mm) there was dural pulsation and prolapse. These findings were constant regardless of the etiology of the lesion and the reconstruction material used.

Conclusion: This long-term study showed that dural pulsation and prolapse at the site of the successful duraplasty is a function of the size of the bony defect and does not depend on the pathology of the lesion or the autologous material used for reconstruction. For any future endonasal procedure for these patients, the surgeons should be fully aware of the state of duraplasty to avoid any complication.

Keywords: CT; dural pulsation; duraplasty; endonasal; endoscopic; ESS; MRI; skull base

Document Type: Research article

DOI: 10.2500/ajr.2008.22.3157

Affiliations: 1: Department of ENT surgery, El Menoufyia University, El Menoufyia, Egypt 2: Department of Neurosurgery, El-Hikmah Hospital, Mansoura, Egypt 3: Department of ENT surgery, El Iman General Hospital, Riyadh, Kingdome of Saudi Arabia 4: Department of ENT, Faculty of Medicine, Ain Shames University, Cairo, Egypt

The full text electronic article is available for purchase. You will be able to download the full text electronic article after payment.

$49.50 plus tax Refund Policy

Or sign up for a free trial

Long-term endonasal endoscopic review of successful duraplasty after endonasal endoscopic skull base surgery