Reconstruction of traumatic skull base defects with alloplastic, resorbable fleece

Abstract

Defects of the frontal skull base can be reconstructed with different types of material. Homologous material possibly involves the risk of infection and thus complicated wound healing. Therefore, alloplastic material seems to be an interesting alternative. In the present paper, we report on a series of 45 patients who underwent reconstruction of the anterior skull base. The defects were localized in different regions and had a maximum diameter of 10 cm2. Of the defects, 39 were closed via a sandwich technique and 12 via an onlay. The rhinosurgical approaches were aimed at closing the defects with Ethisorb, a resorbable collagen texture, and supporting the surgical field with a balloon catheter from below. Postoperative controls were performed after 6 weeks (endoscopy, determination of beta 2-transferrin) and 6 months (CT scans). All defect reconstructions were stable and tight, i.e., neither a CSF leakage nor a meningoencephalocele was found. The healing was completely normal and the endoscopic controls showed a regular mucosal lining over the defects. We conclude that Ethisorb is a useful alternative material in the treatment of frontal skull base defects.