Underlay hourglass-shaped autologous pericranium duraplasty in "key-hole" retrosigmoid approach surgery: Technical report

Mastronardi, Luciano; Cacciotti, Guglielmo; Caputi, Franco; Roperto, Raffaelino; Tonelli, Maria Pia; Carpineta, Ettore; Fukushima, Takanori

doi:10.4103/2152-7806.178521

Cited by 17 publications

(16 citation statements)

References 8 publications

(21 reference statements)

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“…Because of their biological and biomechanical performance, autologous membranes are commonly used in duraplasty procedures [ 15 , 21 – 23 , 31 , 56 ]. For example, periosteum has reported benefits of non-immunogenicity, nontoxicity, ability to be sutured watertight, rapid biological/tissue integration, low cost, and low risk of infection in human studies [ 1 , 24 , 25 , 28 , 29 , 31 ]. Pericranium has been identified as a promising autologous cranio-spinal dura graft material [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Tensile properties of human spinal dura mater and pericranium

Cavelier

Quarrington

Jones

2022

J Mater Sci: Mater Med

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Autologous pericranium is a promising dural graft material. An optimal graft should exhibit similar mechanical properties to the native dura, but the mechanical properties of human pericranium have not been characterized, and studies of the biomechanical performance of human spinal dura are limited. The primary aim of this study was to measure the tensile structural and material properties of the pericranium, in the longitudinal and circumferential directions, and of the dura in each spinal region (cervical, thoracic and lumbar) and in three directions (longitudinal anterior and posterior, and circumferential). The secondary aim was to determine corresponding constitutive stress–strain equations using a one-term Ogden model. A total of 146 specimens were tested from 7 cadavers. Linear regression models assessed the effect of tissue type, region, and orientation on the structural and material properties. Pericranium was isotropic, while spinal dura was anisotropic with higher stiffness and strength in the longitudinal than the circumferential direction. Pericranium had lower strength and modulus than spinal dura across all regions in the longitudinal direction but was stronger and stiffer than dura in the circumferential direction. Spinal dura and pericranium had similar strain at peak force, toe, and yield, across all regions and directions. Human pericranium exhibits isotropic mechanical behavior that lies between that of the longitudinal and circumferential spinal dura. Further studies are required to determine if pericranium grafts behave like native dura under in vivo loading conditions. The Ogden parameters reported may be used for computational modeling of the central nervous system.

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Section: Discussionmentioning

confidence: 99%

Tensile properties of human spinal dura mater and pericranium

Cavelier

Quarrington

Jones

2022

J Mater Sci: Mater Med

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“…However, collection of autologous blood is difficult in patients with anemia, and the method is cumbersome and time consuming. Because the cyst was small in the present patient, we used a commercially available fibrin glue product, Bolheal ® (Teijin, Japan), however, other products such as Beriplast P ® (CSL Behring, USA) or TachoSil ® (Takeda, Japan)[ 3 ] could have been substituted. Hydrofiber dressing is a material used for covering bedsores; it is a simple and useful method to prevent intraoperative cyst fluid leakage by completely filling the cyst wall through absorption of moisture and absorbing cyst fluid.…”

Section: Discussionmentioning

confidence: 99%

Removal of a malignant cystic brain tumor utilizing pyoktanin blue and fibrin glue: Technical note

Hayashi¹,

Sasaki²,

Tomura³

et al. 2017

Surg Neurol Int

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Background:The leakage of cystic fluid during metastatic cystic brain tumor resection may cause tumor dissemination. When the cyst wall is thin, excision without removing the wall is often difficult.Methods:We were able to perform an en bloc resection of a cystic malignant brain tumor after aspirating the cystic fluid, injecting pyoktanin blue into the cyst to stain the cyst walls, and solidifying the empty cyst cavity by filling it with fibrin glue.Results:Pyoktanin blue readily stained the thin cystic walls and enabled visualization of mural damage. Solidification of the tumor made it easier to grasp and facilitated the dissection of tumor margins.Conclusions:This method has the potential to become a useful technique for the resection of malignant cystic brain tumors.

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“…Synthetic materials were absorbable dural substitutes composed of collagen of equine origin (e.g. Tachosil 34 , Tachocomb 44 ), collagen of bovine origin (e.g. Duragen 25,27 /Durepair 27 ), oxidized cellulose (e.g.…”

Section: Duramentioning

confidence: 99%

“…Materials used for sutured grafts included autografts (e.g. fascia 31,43 or pericranium 34 ), xenografts 29 and synthetic dural substitutes 7 . Suture materials consisted of 4-0 nurolon 29 , 3-0 silk 7,34 , and 4-0 nylon 7 .…”

Section: Duramentioning

confidence: 99%

Skull Base Repair following Resection of Vestibular Schwannoma: A Systematic Review (Part 1: The Retrosigmoid Approach)

Starup-Hansen,

Williams,

Valetopoulou

et al. 2023

J Neurol Surg B Skull Base

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Objective: Despite advances in skull-base reconstruction techniques, CSF leaks remain a common complication following retrosigmoid (RS) vestibular schwannoma (VS) surgery. We aimed to review and classify the available strategies used to prevent CSF leaks following RS VS surgery. Methods: A systematic review, including studies of adults undergoing RS VS surgery since 2000, was conducted. Repair protocols were synthesised into a narrative summary, and a taxonomic classification of techniques and materials was produced. Additionally, the advantages, disadvantages, and associated CSF leak rates of different repair protocols were described. Results: All 42 studies were case series, of which 34 were retrospective, and eight were prospective. Repair strategies included heterogeneous combinations of autografts, xenografts, and synthetic materials. A repair taxonomy was produced considering seven distinct stages to CSF leak prevention, including intraoperative approaches to the dura, internal auditory canal (IAC), air cells, RS bony defect, extra-cranial soft tissue, post-operative dressings, and CSF diversion. Notably, there was significant heterogeneity among institutions, particularly in the dural and IAC stages. The median postoperative incidence of CSF leaks was 6.3% (IQR 1.3%-8.44%). Conclusions: The intra-operative strategies used to prevent CSF leaks during RS VS surgery vary significantly between and within institutions. As a result of this heterogeneity and inconsistent reporting of CSF leak predictive factors, a meaningful comparative analysis of repair protocols was not feasible. Instead, we propose the development of a prospective multi-centre service evaluation designed to accurately capture a comprehensive dataset of potential CSF risk factors, including all stages of the operative repair protocol.

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Underlay hourglass-shaped autologous pericranium duraplasty in "key-hole" retrosigmoid approach surgery: Technical report

Cited by 17 publications

References 8 publications

Tensile properties of human spinal dura mater and pericranium

Tensile properties of human spinal dura mater and pericranium

Removal of a malignant cystic brain tumor utilizing pyoktanin blue and fibrin glue: Technical note

Skull Base Repair following Resection of Vestibular Schwannoma: A Systematic Review (Part 1: The Retrosigmoid Approach)

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