Double collagen matrix grafting for dural closure in microvascular decompression: an alternative use of autologous fascial grafting

被引:8
作者
Inoue, Takuro [1 ]
Shitara, Satoshi [1 ]
Shima, Ayako [1 ]
Goto, Yukihiro [2 ]
Fukushima, Takanori [3 ]
机构
[1] Subarukai Koto Mem Hosp, Dept Neurosurg, 2-1 Hiramatsu Cho, Higashiohmi, Shiga 5270134, Japan
[2] Saiseikai Shiga Hosp, Dept Neurosurg, Shiga, Japan
[3] Duke Univ, Med Ctr, Div Neurosurg, Durham, NC 27710 USA
关键词
Collagen matrix graft; DuraGen; Dural reconstruction; Microvascular decompression; Surgical technique; POSTOPERATIVE HEADACHE; SURGERY; MANAGEMENT; LEAK; RECONSTRUCTION; RESECTION;
D O I
10.1007/s00701-021-04856-6
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Watertight dural closure is a crucial step in preventing postoperative cerebrospinal fluid (CSF) leak and subsequent infection in posterior fossa surgery. The aim of this study is to assess an alternative use of collagen matrix double grafting in microvascular decompression (MVD). Methods Dural closure using double collagen matrix grafts was retrospectively compared with autologous fascial grafting in 120 patients who underwent MVD. Double collagen matrix grafting technique, a combination use of inlay and onlay grafting (DuraGen(R), Integra Lifesciences, Plainsboro, NJ, USA, $700-800 for an MVD craniotomy size), was applied in 60 patients (the collagen matrix group). In the remaining 60 patients, an autologous fascial graft was sutured in a watertight fashion to the dural defect (the fascia group). Postoperative wound complications, such as CSF leak and infection, were retrospectively compared between the two groups. Results CSF leaks were observed in 3 patients (5.0%) in the fascia group and in 2 patients (3.3%) in the collagen matrix group. All cases of CSF leakage presented with pseudomeningoceles except one patient who developed an incisional CSF leak. A repair surgery for CSF leak was required in this one patient in the fascia group. Subcutaneous abscesses were noted in 2 patients (3.3%) in the fascia group. There was no patient who developed a subcutaneous abscess in the collagen matrix group. One patient in each group developed aseptic meningitis. Statistical analyses revealed that the collagen matrix group showed non-inferior outcomes to the fascia group in CSF leaks and infectious complications. Conclusions Double grafting technique with a combination of inlay and onlay collagen sheets is a safe and secure alternative for watertight dural closure despite a cost limitation.
引用
收藏
页码:2395 / 2401
页数:7
相关论文
共 23 条
[11]   A prospective cohort study of microvascular decompression and Gamma Knife surgery in patients with trigeminal neuralgia [J].
Linskey, Mark E. ;
Ratanatharathorn, Vaneerat ;
Penagaricano, Jose .
JOURNAL OF NEUROSURGERY, 2008, 109 :160-172
[12]   DURAL AUGMENTATION: PART I-EVALUATION OF COLLAGEN MATRIX ALLOGRAFTS FOR DURAL DEFECT AFTER CRANIOTOMY [J].
Litvack, Zachary N. ;
West, G. Alexander ;
Delashaw, Johnny B. ;
Burchiel, Kim J. ;
Anderson, Valerie C. .
NEUROSURGERY, 2009, 65 (05) :890-897
[13]   A CLINICOPATHOLOGICAL STUDY OF COLLAGEN SPONGE AS A DURAL GRAFT IN NEUROSURGERY [J].
NAROTAM, PK ;
VANDELLEN, JR ;
BHOOLA, KD .
JOURNAL OF NEUROSURGERY, 1995, 82 (03) :406-412
[14]   Collagen matrix duraplasty for cranial and spinal surgery: a clinical and imaging study [J].
Narotam, Pradeep K. ;
Reddy, Kesava ;
Fewer, Derek ;
Qiao, Fan ;
Nathoo, Narendra .
JOURNAL OF NEUROSURGERY, 2007, 106 (01) :45-51
[15]   Collagen matrix duraplasty for posterior fossa surgery: evaluation of surgical technique in 52 adult patients Clinical article [J].
Narotam, Pradeep K. ;
Qiao, Fan ;
Nathoo, Narendra .
JOURNAL OF NEUROSURGERY, 2009, 111 (02) :380-386
[16]   Intraoperative management to prevent cerebrospinal fluid leakage after microvascular decompression: dural closure with a "plugging muscle" method [J].
Park, Jae Sung ;
Kong, Doo-Sik ;
Lee, Jeong-A. ;
Park, Kwan .
NEUROSURGICAL REVIEW, 2007, 30 (02) :139-142
[17]   Non-watertight dural reconstruction in meningioma surgery: results in 439 consecutive patients and a review of the literature Clinical article [J].
Sade, Burak ;
Oya, Soichi ;
Lee, Joung H. .
JOURNAL OF NEUROSURGERY, 2011, 114 (03) :714-718
[18]   Microvascular decompression to treat hemifacial spasm:: Long-term results for a consecutive series of 143 patients [J].
Samii, M ;
Günther, T ;
Iaconetta, G ;
Muehling, M ;
Vorkapic, P ;
Samii, A .
NEUROSURGERY, 2002, 50 (04) :712-718
[19]   Cerebrospinal fluid (CSF) leak and pseudomeningocele formation after posterior fossa tumor resection in children: a retrospective analysis [J].
Steinbok, P. ;
Singhal, A. ;
Mills, J. ;
Cochrane, D. D. ;
Price, A. V. .
CHILDS NERVOUS SYSTEM, 2007, 23 (02) :171-174
[20]   Decreased Rate of CSF Leakage Associated with Complete Reconstruction of Suboccipital Cranial Defects [J].
Stoker, Michael A. ;
Forbes, Jonathan A. ;
Hanif, Rimal ;
Cooper, Calvin ;
Nian, Hui ;
Konrad, Peter E. ;
Neimat, Joseph S. .
JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE, 2012, 73 (04) :281-286