DIFFERENT SURGICAL TECHNIQUES OF SKULL BASE RECONSTRUCTION: EVALUATION AND OUTCOME

Abstract

ABSTRACT
Background : cerebrospinal fluid (CSF) leak is the most common complication after skull base surgery. It carries
a high risk of life threatening complications (e.g., tension pneumocephaly, meningitis, cerebritis, and brain
abscess).
Patients and Methods: We present twenty patients, ages 2-55 years, eight males and twelve females with
different skull base pathologies operated by different surgical modalities (microscopic transcranial, endoscopic
endonasal and combined micro-endoscopic techniques) at neurosurgery department, faculty of medicine, Zagazig
University, between Jan. 2016 to Jan. 2018. Prophylactic antibiotics and anticonvulsants were rourtinely given.
Lumbar drain was not used.
Results: the success rate was (95%) and only one patient (5%) developed post operative CSF leak which
responded to conservative measures. This suggests that proper sealing of the skull base defect has been achieved.
There was no infection, no mortality and the long term follow up showed good functional and aesthetic results.
Conclusion: The reconstructive process although being the last step in the surgical procedure, but it's a very
important one. It should be planned well before surgery. Meticulous repair of the already present or resultant
defect should be performed in every case.
Key words: Skull base defect, skull base reconstruction, cerebrospinal fluid leakage, dural reconstruction.