Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature
Introduction: The reconstruction of frontobasal defects following oncologic resections of paranasal and anterior skull base (ASB) malignancies remains challenging. Ineffective reconstruction could lead to cerebrospinal fluid leak, meningitis, and tension pneumocephalus. Research question: Aim of thi...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
|
| Series: | Brain and Spine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529423010287 |
| _version_ | 1826932815868985344 |
|---|---|
| author | Björn Sommer Ina Konietzko Maximilian Niklas Bonk Tina Schaller Bruno Märkl Klaus Henning Kahl Georg Stüben Johannes Zenk Ehab Shiban |
| author_facet | Björn Sommer Ina Konietzko Maximilian Niklas Bonk Tina Schaller Bruno Märkl Klaus Henning Kahl Georg Stüben Johannes Zenk Ehab Shiban |
| author_sort | Björn Sommer |
| collection | DOAJ |
| description | Introduction: The reconstruction of frontobasal defects following oncologic resections of paranasal and anterior skull base (ASB) malignancies remains challenging. Ineffective reconstruction could lead to cerebrospinal fluid leak, meningitis, and tension pneumocephalus. Research question: Aim of this investigation was to analyse postoperative complication rates with or without bone graft for anterior skull base reconstruction. Material and methods: In this retrospective study, we included patients following resection of paranasal and/or anterior skull base malignancies between October 2013 and December 2022. Complications were analysed with regards to the type of skull base reconstruction. Results: Eleven patients were identified (2 female, 9 male, age (median, SD) 64 ± 14.1 years (range 38–81). There were nine cases of paranasal sinus and nasal cavity carcinomas and two cases of olfactory neuroblastomas. Overall survival was 22.5 ± 28 months (range: 5–78), progression free survival was 17.0 ± 20.3 months (range: 11–78). Bone skull base reconstruction using a split graft was performed in three cases. Postoperative complications requiring surgical intervention were seen in 33% (one tension pneumocephalus) of cases in the bone reconstruction group and 50% (three patients with cerebrospinal fluid leak, one infection) in the non-bone reconstruction group. Discussion and conclusion: The structural reinforcement of structural bone chip grafting might provide additional support of the ASB and prevent CSF leakage or encephalocele. Especially in large (>10 cm2) bone defects of advanced sinonasal malignancies extending into the middle cranial fossa, the full armamentarium of reconstruction possibilities should be considered. |
| first_indexed | 2024-03-08T16:32:15Z |
| format | Article |
| id | doaj.art-5f843609a0dd470cb484d404b8d9d5d4 |
| institution | Directory Open Access Journal |
| issn | 2772-5294 |
| language | English |
| last_indexed | 2025-02-17T17:21:39Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj.art-5f843609a0dd470cb484d404b8d9d5d42024-12-15T06:18:05ZengElsevierBrain and Spine2772-52942024-01-014102740Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literatureBjörn Sommer0Ina Konietzko1Maximilian Niklas Bonk2Tina Schaller3Bruno Märkl4Klaus Henning Kahl5Georg Stüben6Johannes Zenk7Ehab Shiban8Department of Neurosurgery, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany; Corresponding author.Department of Neurosurgery, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, GermanyDepartment of Neurosurgery, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, GermanyDepartment of Pathology, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, GermanyDepartment of Pathology, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, GermanyDepartment of Radiation Therapy, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, GermanyDepartment of Radiation Therapy, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, GermanyDepartment of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, GermanyDepartment of Neurosurgery, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, GermanyIntroduction: The reconstruction of frontobasal defects following oncologic resections of paranasal and anterior skull base (ASB) malignancies remains challenging. Ineffective reconstruction could lead to cerebrospinal fluid leak, meningitis, and tension pneumocephalus. Research question: Aim of this investigation was to analyse postoperative complication rates with or without bone graft for anterior skull base reconstruction. Material and methods: In this retrospective study, we included patients following resection of paranasal and/or anterior skull base malignancies between October 2013 and December 2022. Complications were analysed with regards to the type of skull base reconstruction. Results: Eleven patients were identified (2 female, 9 male, age (median, SD) 64 ± 14.1 years (range 38–81). There were nine cases of paranasal sinus and nasal cavity carcinomas and two cases of olfactory neuroblastomas. Overall survival was 22.5 ± 28 months (range: 5–78), progression free survival was 17.0 ± 20.3 months (range: 11–78). Bone skull base reconstruction using a split graft was performed in three cases. Postoperative complications requiring surgical intervention were seen in 33% (one tension pneumocephalus) of cases in the bone reconstruction group and 50% (three patients with cerebrospinal fluid leak, one infection) in the non-bone reconstruction group. Discussion and conclusion: The structural reinforcement of structural bone chip grafting might provide additional support of the ASB and prevent CSF leakage or encephalocele. Especially in large (>10 cm2) bone defects of advanced sinonasal malignancies extending into the middle cranial fossa, the full armamentarium of reconstruction possibilities should be considered.http://www.sciencedirect.com/science/article/pii/S2772529423010287Skull base tumorResectionDural repairComplicationsTechnique |
| spellingShingle | Björn Sommer Ina Konietzko Maximilian Niklas Bonk Tina Schaller Bruno Märkl Klaus Henning Kahl Georg Stüben Johannes Zenk Ehab Shiban Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature Brain and Spine Skull base tumor Resection Dural repair Complications Technique |
| title | Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature |
| title_full | Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature |
| title_fullStr | Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature |
| title_full_unstemmed | Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature |
| title_short | Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature |
| title_sort | dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies retrospective single center analysis of 11 cases and review of literature |
| topic | Skull base tumor Resection Dural repair Complications Technique |
| url | http://www.sciencedirect.com/science/article/pii/S2772529423010287 |
| work_keys_str_mv | AT bjornsommer duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature AT inakonietzko duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature AT maximilianniklasbonk duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature AT tinaschaller duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature AT brunomarkl duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature AT klaushenningkahl duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature AT georgstuben duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature AT johanneszenk duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature AT ehabshiban duralreconstructionwithorwithoutabonegraftofparanasalandanteriorskullbasemalignanciesretrospectivesinglecenteranalysisof11casesandreviewofliterature |