ABSTRACTcongenital diseases. It is a common clinical phenomenon, but successful repair of the defect is always a difficulty for neurosurgeons. The current closure techniques cannot be fully satisfactory (8,10,12,22,27). However, soldering with CO 2 laser has significant advantages and this technique is an alternative method for the reconstruction of dural defects (7). There are many studies on dural repair with the CO 2 laser, but the survival time of the experimental animals was not longer than 10 days in these studies.The aim of this study was to create a minipig model to explore the feasibility and reliability of the CO 2 laser system for the reconstruction of dura mater in the early postoperative and late follow-up periods.
█ INTRODUCTIONIn 1960, the first laser device was designed by Maiman in the USA. Since that time, many different types of laser have been developed and used among the medical specialties such as ophthalmology, dermatology, gynecology, oncology and surgery (2,14,16,17,19,24,26). The radiation of the CO 2 laser is highly absorbed in water and it has a shallow penetration depth (<20µm) (7,8). The heat is propagated into the tissues by conduction (8). It therefore does not cause any secondary damage to the surrounding tissue. In time, the CO 2 laser was liked and used by more physicians and clinics.Dural defects may be secondary to trauma, tumor erosion, surgical procedures, inflammatory destruction and some AIM: To explore the feasibility and reliability of CO 2 laser soldering on the reconstruction of dura mater in the minipig model.
MATERIAl and METhODS:Ten minipigs were divided into 2 groups as Group A (n=5) and Group B (n=5). Bilateral fronto-parietal craniotomy was performed and 2cm×1cm dural defect created under general anesthesia. Then, the defect was repaired with autologous temporalis fascia by CO 2 laser soldering. After pressure and watertightness testing, the minipigs of group A were sacrificed immediately. Minipigs in Group B were followed for 4 weeks, with daily monitoring of behavior, food intake, skin incision and neurological condition. Animals of Group B were also subjected to the same tests as group A. Then, they were also sacrificed. The reconstructed area and underlying brain tissue were fixed in paraformaldehyde and submitted for histological analysis.
RESUlTS:No neural impairment, hydrops or empyema, and no cerebrospinal fluid leak in the dura-fascia interface were observed in Group B. The mean burst pressures were higher than the mean intracranial crest pressure in groups A and B. This difference was significant (P=0.010, P=0.000, respectively). The physiological intracranial pressure of ten minipigs ranged between 4.53 and 6.47 mmHg. No thermal injury was observed in either group. CONClUSION: CO 2 laser soldering for dural defect reconstruction was feasible and reliable.