Abstract
Objective To describe the techniques for the reconstruction of skull base defects after minimally invasive endoscopic resection of skull base chordomas.Methods The records of 146 patients who presented with skull base chordomas between Aug.2007 and Oct.2013 were retrospectively reviewed.The skull base defects after endoscopic endonasal resection of the chordomas were classified according to the dimensions of the dural defects as the following:(Type Ⅰ) The dura of skull base was intact after the tumour resection (113 cases) ; (Type Ⅱ) The dural defect was equal or less than 1 cm (12 cases) ; (Type Ⅲ) The dural defect was greater than 1 cm (21 cases).Three different reconstruction methods were utilized according to the classification of the skull base defects.The reconstruction of the type Ⅰ defect was performed mainly using artificial material; type Ⅱ in a multilayer fashion,mainly using an array of autologous free material including fat,muscle,muscle fascia and artificial material; type Ⅲ using vascular pedicle nasoseptal flap and autologous free material.Results There was no case of postoperative cerebrospinal fluid (CSF) leakage occurred following the reconstruction of type Ⅰ.One case of postoperative CSF leak (8.3％) occurred following the reconstruction of type Ⅱ and two (9.5％) occurred following the reconstruction of type Ⅲ.The rate of postoperative CSF leakage of all the cases is 2.1％.Conclusions Different reconstruction methods should be chosen according to different types of skull base defects.Reducing the use of vascular pedicle nasoseptal flap as much as possible could minimize the trauma of nasal cavity,increase the degree of comfort of the patients and offer convenience for the next skull base reconstruction after the resection of recurrent chordomas. Key words: Chordoma; Endoscopic ; Skull base reconstruction
Published Version
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