Tamponade with Chitin-Coated Gauze Following Nasal Surgery.

Cranial Base Repair Using Suturing Technique Combined with a Mucosal Flap for Cerebrospinal Fluid Leakage During Endoscopic Endonasal Surgery

“…In addition, after completing multilayered cranial base repair, the graft and mucosal flap were gently bolstered by packing the sphenoid sinus with Beschitin-F sponge with gauze, which contains material made from crab shells, preventing adhesion with the mucosa and promoting healing of the mucosa. 23 We did not use a sinus balloon because it is difficult to control pressure to the graft and the cranial base, and it has the risk of causing optic nerve compression or necrosis of the NSF owing to compression of the feeding artery. 23 Our multilayered repair is applicable to a wide variety of skull base lesions, including recurrent cases or cases with a large dural defect.…”

“…23 We did not use a sinus balloon because it is difficult to control pressure to the graft and the cranial base, and it has the risk of causing optic nerve compression or necrosis of the NSF owing to compression of the feeding artery. 23 Our multilayered repair is applicable to a wide variety of skull base lesions, including recurrent cases or cases with a large dural defect. In our method, dural suturing is helpful for preventing migration of the graft material as well as providing counterpressure against CSF pulsation, although counterpressure is weaker than a gasket seal or other hard buttress.…”