Summary
Background. Reconstruction of the skull base after resection of a tumour is important to prevent postoperative complications such as infectionsand cerebrospinal fluid (CSF) leakage. Several reconstructive methods of the anterior skull base have been reported but, their long-term results are not clear.
Methods. We describe a technique used after removal of an olfactory neuroblastoma with infiltration of the skull base. The reconstructed dura was covered with a galeal patch, a replicated galeal-pericranial flap, a graft from the inner table of skull, and a vascularised galeal-pericranial flap placed on the skull base defect. All layers were fixed with fibrin glue.
Conclusion. Three dimensional computed tomography (3D-CT) at bone window settings demonstrated the bone graft covered the bone defect and was not absorbed and after 11 years there have been no signs of tumour regrowth or complications.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- CSF:
-
CerebroSpinal Fluid
- CT:
-
Computed Tomography
- MRI:
-
Magnetic Resonance Imaging
- 3D:
-
Three Dimensional
References
G Cantu CL Solero L Mariani P Salvatori F Mattavelli N Pizzi Riggio (1999) ArticleTitleAnterior craniofacial resection for malignant ethmoid tumors – a series of 91 patients Head Neck 21 185–191 Occurrence Handle10208659 Occurrence Handle10.1002/(SICI)1097-0347(199905)21:3<185::AID-HED1>3.0.CO;2-8 Occurrence Handle1:STN:280:DyaK1M3itlemug%3D%3D
WT Couldwell (1993) ArticleTitleSurgery of the anterior skull base Otolaryngol Clin North Am 26 673–693 Occurrence Handle8414533 Occurrence Handle1:STN:280:DyaK2c%2FitVylsg%3D%3D
F DeMonte DR Fourney AS Garden EM Daiz SuffixJr (2005) Carcinoma of the paranasal sinuses and olfactory neuroblastoma MS Berger MD Prados (Eds) Textbook of neuro-oncology Elsevier Saunders Philadelphia 371–384
DM Fliss Z Gil S Spektor L Leider-Trejo A Abergel A Khafif A Amir E Gur JT Cohen (2002) ArticleTitleSkull base reconstruction after anterior subcranial tumor resection Neurosurg Focus 12 IssueID5 e10 Occurrence Handle16119898
SP Hao (2001) ArticleTitleFacial translocation approach to the skull base: The viability of translocated facial bone graft Otolaryngol Head Neck Surg 124 292–296 Occurrence Handle11240994 Occurrence Handle10.1067/mhn.2001.112308 Occurrence Handle1:STN:280:DC%2BD3MzitlCksg%3D%3D
DJ Howard VJ Lund WI Wei (2006) ArticleTitleCraniofacial resection for tumors of the nasal cavity and paranasal sinuses: a 25-year experience Head Neck 28 867–873 Occurrence Handle16823871 Occurrence Handle10.1002/hed.20432
JT Kryzanski DJ Annino SuffixJr CB Heilman (2002) ArticleTitleComplication avoidance in the treatment of malignant tumors of the skull base Neurosurg Focus 12 IssueID5 e11 Occurrence Handle16119899 Occurrence Handle10.3171/foc.2002.12.5.12
JK Liu Z Niazi WT Couldwell (2002) ArticleTitleReconstruction of the skull base after tumor resection: an overview of methods Neurosurg Focus 12 IssueID5 e9 Occurrence Handle16119907
RJ Oskouian SuffixJr JA Jane SuffixSr AS Dumont JM Sheehan JJ Laurent PA Levine (2002) ArticleTitleEsthesioneuroblastoma: clinical presentation, radiological, and pathological features, treatment, review of the literature, and the University of Virginia experience Neurosurg Focus 12 IssueID5 e4 Occurrence Handle16119902
M Rodrigues BW O’malley H Staecker R Tamargo (2004) ArticleTitleExtended pericranial flap and bone graft reconstruction in anterior skull base surgery Otolaryngol Head Neck Surg 131 69–76 Occurrence Handle15243560 Occurrence Handle10.1016/j.otohns.2004.02.033
JP Shah DH Kraus MH Bilsky PH Gutin LH Harrison EW Strong (1997) ArticleTitleCraniofacial resection for malignant tumors involving the anterior skull base Arch Otolaryngol Head Neck Surg 123 1312–1317 Occurrence Handle9413360 Occurrence Handle1:STN:280:DyaK1c%2FnsFarsw%3D%3D
JM Sheehan JA Jane SR (2004) Esthesioneuroblastoma H Richard Winn (Eds) Youmans neurological surgery EditionNumber5 Elsevier Saunders Philadelphia 1333–1341
ML Urken H Weinberg D Buchbinder JF Moscoso W Lawson PJ Catalano HF Biller (1994) ArticleTitleMicrovascular free flaps in head and neck reconstruction. Report of 200 cases and review of complications Arch Otolaryngol Head Neck Surg 120 633–640 Occurrence Handle8198786 Occurrence Handle1:STN:280:DyaK2c3lslaiuw%3D%3D
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Abe, T., Goda, M., Kamida, T. et al. Overlapping free bone graft with galea-pericranium in reconstruction of the anterior skull base to prevent CSF leak and sequestrum formation. Acta Neurochir (Wien) 149, 771–775 (2007). https://doi.org/10.1007/s00701-007-1227-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-007-1227-9