Biomaterialien in der Schädelbasischirurgie

Abstract

Reconstruction materials and techniques for the skull base have undergone rapid developments and differentiation in recent years. While mostly autotransplants, collagens or resorbable alloplastic materials are preferred for duraplasties, pronounced organ-specific differences can be observed IN the reconstruction of hard tissues. The use of polymethylmethacryl bone cement, once wide-spread, has decreased greatly due to the release of toxic monomers. Bony autotransplants are still used primarily for smaller skull-base defects, intraoperatively formable titanium meshes may be also used for larger fronto- or laterobasal reconstructions of bony defects. Defects in visible areas are increasingly closed with preformed titanium or ceramic implants, which are planned and fitted to the individual patient using preoperative CT imaging. At the skull base, this applies especially to reconstructions of the frontal sinus. For extensive reconstructions of the orbita, titanium meshes and non-resorbable plastics have proven valuable, in closing smaller defects especially of the orbital floor, resorbable implants based on Polyglactin 901 are also used.

The transnasal approach to the skull base. From sinus surgery to skull base surgery

“…When there are reasons that preclude the use of autologous transplants, several alloplastic materials can be applied [ 51 ], [ 52 ], [ 53 ], [ 54 ], [ 55 ]. A uniform opinion on their suitability does not exist [ 40 ].…”

Kommentar der Schriftleitung

“…Die kindliche OSA ist Thema der " Ü bersicht " , die Empfehlungen f ü r die Erfolgsauswertung nach operativen Eingriff en enth ä lt [4] . Zwei " Interessante F ä lle " befassen sich mit Osteolysen des Felsenbeins und der Rekonstruktion nach Entfernung eines subglottischen Tumors, wobei Biomaterialien zum Einsatz kamen [5] . " Gutachten und Recht " besch ä ftigt sich mit ungew ö hnlichen Tonschwellenverl ä ufen im Audiogramm bei L ä rmarbeitern und die " Fortbildung " greift das wichtige Thema der individualisierten Krebstherapie mithilfe von Biomarkern auf, wie sie bei anderen Organtumoren, z.…”