Skull base reconstruction barrier in endoscopic endonasal approaches

Abstract

Introduction: Endoscopic endonasal approaches are the procedures of choice for medial tumors in the cranial base given their safety and effectiveness. Repair of the cranial base constitutes a high challenge. Objective: To evaluate the effectiveness of constructing a cranial base reconstruction barrier in patients with cranial base tumors operated on by endoscopic endonasal approaches. Method: A descriptive study was carried out, which included 70 patients from the Hermanos Ameijeiras Hospital operated on for cranial base tumors using endoscopic endonasal approaches. A cranial base repair barrier was constructed to isolate the sinonasal and intracranial compartments. The efficiency of the repair barrier was determined through clinical and endoscopic aspects. Aspects were defined to be evaluated in relation to the vitality of the repair barrier with the use of fibrin rich in platelets and leukocytes. Results: An efficient repair barrier was evident in 98.6%. In relation to the state of vitality of the barrier, adhesion and granulation were observed in 98.6% of patients, while angiogenesis was observed in 97.1%. The incidence of postoperative cerebrospinal fluid leak was only 1.4%. Conclusions: The present study shows the positive effect of the construction of an efficient repair barrier of the cranial base in endoscopic endonasal approaches with a significant reduction in cerebrospinal fluid leak and its complications.

Keywords

• base del cráneo
• endoscopía
• fibrina rica en plaquetas y leucocitos
• pérdida de líquido cefalorraquídeo.