A New Technique for Single-Person Fascia Lata Graft Harvesting

Abstract

Reconstitution of a water-tight dural closure at the conclusion of skull base surgery is a very important step in the operation to prevent cerebrospinal fluid leak, encephalocele formation, or infection. Often, sufficient native dura is not available to accomplish this goal and a dural substitute is required. Options include nonautologous, commercially available products or autologous tissue harvested at the time of the primary operation. Autologous tissue has the advantage of no risk of foreign body reaction and very low risk of infection, even if exposed to paranasal sinuses, etc. It is also readily available but often requires a separate incision and added operative time to perform the harvest procedure. We have developed a system of single-person fascia lata harvest that is fast, safe, and easily mastered. It reliably produces a large volume of high-quality fascia that can be used in a variety of skull base procedures. It requires only simple instrumentation and because the harvesting is done by one person, it can proceed independently of the main operation, thus eliminating any added operative time and inconvenience. We have used this technique on 23 patients in the past 12 months with good results.