Surgical Technique for the Prevention of Cerebrospinal Fluid Leakage After Bifrontal Craniotomy

Murai, Yasuo; Mizunari, Takayuki; Kobayashi, Shiro; Teramoto, Akira

doi:10.1016/j.wneu.2013.01.032

Cited by 17 publications

(24 citation statements)

References 30 publications

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“…Previously, 51 consecutive patients underwent bifrontal craniotomy with exposed and violated FS (19). The surgical technique included direct suture of the exposed and violated FS mucosa with pericranial flap, and none of the 51 patients developed postoperative CSF leakage or meningitis (19). In the present study, the frequencies of CSF leakage and infectious complications were 0% and 1.0%, respectively, which are significantly lower than frequencies previously reported.…”

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

“…Our policy is consistent with such an approach to training. Second, this method does not require spinal CSF drainage, so drainage-related complications, including low intracranial pressure, intracranial hematoma, and infection, can be avoided (19).…”

Section: Discussionmentioning

confidence: 99%

“…For many years, we have used a surgical technique based on direct suture of the exposed and violated FS mucosa because it is important to leave the NFD open and to seal the FS mucosa completely. However, this technique has rarely been reported and discussed (19). In the present study, we describe in detail Abbreviations and Acronyms CSF: Cerebrospinal fluid FS: Frontal sinus NFD: Nasofrontal duct our procedure for treating the exposed FS during bifrontal craniotomy and discuss the results and outcomes of our procedure.…”

Section: Introductionmentioning

confidence: 96%

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An Effective Method of Frontal Sinus Reconstruction After Bifrontal Craniotomy: Experience with 103 Patients

et al. 2015

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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An Effective Method of Frontal Sinus Reconstruction After Bifrontal Craniotomy: Experience with 103 Patients

et al. 2015

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“…One method 2,6,8 to prevent these complications is the use of a free flap for reconstruction of the skin, dura, and supporting tissue after tumor removal. The temporal, facial, or cervical artery is often used as a donor vessel for the flap 9 .…”

Section: Introductionmentioning

confidence: 99%

Second Free Flap Surgery for Skull Base Tumors: Case Report and Literature Review

et al. 2019

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Tumors of the skull base, such as meningiomas, tend to recur. With progress in free vascularized flap surgery, an increasing number of studies are investigating skull base reconstruction with free flaps after tumor removal. In this report, we discuss the results of second free flap surgery after skull base reconstructive surgery. We retrospectively analyzed data from patients treated at our center during the period from 2013 through 2017. All four patients identified had skull base anaplastic meningioma and had undergone radiotherapy. In all cases, the flap and donor blood vessel were sourced from sites that differed from those used in the previous surgeries. No complications developed, such as cerebrospinal fluid leakage, meningitis, wound infection, wound hemorrhage, or flap necrosis. Because the first flap was found to be unviable, it was difficult to preserve and was removed. Essential points in preventing complications are anchoring at the appropriate site, pinprick testing of the created flap, and use of multilayered countermeasures to prevent cerebrospinal fluid leakage. (J Nippon Med Sch 2019; 86: 248 253)

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Olfactory preservation during anterior interhemispheric approach for anterior skull base lesions: technical note

et al. 2015

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Anosmia is not a rare complication of surgeries that employ the anterior interhemispheric approach. Here, we present a fibrin-gelatin fixation method that provides reinforcement and moisture to help preserve the olfactory nerve when using the anterior interhemispheric approach and describe the results and outcomes of this technique. We analyze the outcomes with this technique in 45 patients who undergo surgery for aneurysms, brain tumors, or other pathologies via the anterior interhemispheric approach. Anosmia occurred in 4 patients (8.8%); it was transient in 2 (4.4%) and permanent in the remaining 2 (4.4%). Brain tumors clearly attached to the olfactory nerve were resected in the patients with permanent anosmia. We found a significant difference in the presence of anosmia between patients with or without lesions that were attaching the olfactory nerve (p = 0.011). Our results suggested that fibrin-gelatin fixation method can reduce the reported risk of anosmia. However, the possibility of olfactory nerve damage is relatively high when operating on brain tumors attaching olfactory nerve.

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Surgical Technique for the Prevention of Cerebrospinal Fluid Leakage After Bifrontal Craniotomy

Cited by 17 publications

References 30 publications

An Effective Method of Frontal Sinus Reconstruction After Bifrontal Craniotomy: Experience with 103 Patients

An Effective Method of Frontal Sinus Reconstruction After Bifrontal Craniotomy: Experience with 103 Patients

Second Free Flap Surgery for Skull Base Tumors: Case Report and Literature Review

Olfactory preservation during anterior interhemispheric approach for anterior skull base lesions: technical note

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