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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2018; 79(02): e31-e35
DOI: 10.1055/s-0038-1645886
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Anterior Skull Base Reconstruction: Does Fat Preparation Matter?

Joshua Wood
1   Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Jaron Densky
2   Department of Otolaryngology, Head and Neck Surgery, Ohio State University, Columbus, Ohio, United States
,
John Boughter
3   Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Merry Sebelik
4   Department of Otolaryngology, Head and Neck Surgery, Emory University, Atlanta, Georgia, United States
,
Courtney Shires
1   Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
› Author Affiliations
Further Information

Publication History

10 October 2017

12 March 2018

Publication Date:
11 May 2018 (online)

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Abstract

Objectives This article aims (1) to determine whether there is any difference in cerebrospinal fluid (CSF) leak rate after anterior skull base autologous fat reconstruction based on how the fat is prepared, and (2) to measure impact on surgical times by reconstruction type.

Design Translational animal model surgical technique 3-arm trial, comparing two different methods of autologous fat skull base reconstruction versus a nonreconstructed control group.

Setting Animal study.

Subjects Adult Sprague-Dawley rats.

Main Outcome Measures Resolution of CSF rhinorrhea after repair of a surgically created anterior skull base defect.

Results Both wet (uncompressed) and dry (compressed) fat reconstruction of an anterior skull base defect demonstrated lower CSF leak rates than nonreconstructed defects. Dry fat reconstruction achieved significance in superiority of controlling CSF leak over no reconstruction (64% success vs. 31%); while wet fat reconstruction trended toward significance (50% vs. 31%). Reconstruction procedure time was longer than nonreconstructed controls, but there was no significant difference between type of fat preparation in surgical time.

Conclusions This study demonstrates that drying and compressing the fat graft improves autologous fat reconstruction success for anterior skull base defects, and does not add significantly to surgical time over nonprepared fat.

Keywords

autologous fat graft - cerebrospinal fluid leak - anterior skull base - skull base reconstruction

Note

This was presented as an oral presentation at the North American Skull Base Society Annual Meeting in February 20–22, 2015.


 

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