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Augmented Autologous Pericranium Duraplasty in 100 Posterior Fossa Surgeries - A Retrospective Case Series.
MedLine Citation:
PMID:  22843136     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Primary closure of the dura in posterior fossa (p-fossa) surgeries is technically difficult and usually requires the use of a dural substitute. A variety of substitutes are currently available and data suggest that autologous materials are preferred compared to non-autologous substitutes. OBJECTIVE:: To report our experience using locally harvested autologous pericranium as a dural substitute in patients who underwent p-fossa surgeries. METHODS:: Retrospective analysis of patients who had undergone p-fossa craniotomies between 2005 and 2011. All patients received locally harvested autologous pericranium for duraplasty augmented with a dural sealant. Data were reviewed for complications including: surgical site infection, meningitis, cerebrospinal fluid leak, the radiographic formation of a pseudomeningocele, and any new neurological symptoms related to the incision or repair. RESULTS:: One hundred patients were identified. Indications for surgery included: tumor, vascular lesions, or hemorrhage requiring surgical intervention; symptomatic Chiari I malformation; microvascular decompression for trigeminal neuralgia; and trauma requiring surgical decompression. The complication rate was 1% with one patient developing an NSAID induced aseptic meningitis and graft dehiscence requiring surgical revision. CONCLUSION:: Autologous pericranium with dural sealant augmentation is an effective way to repair the durotomy in p-fossa surgeries. To the best of our knowledge, this is currently the largest study using this technique in the adult neurosurgical literature. Our results report a much lower rate of complications compared to other duraplasty studies.
Authors:
Fred C Lam; Ekkehard Kasper
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-26
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts.
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