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Skull base surgery. 1999; 9(1): 9–13.
PMCID: PMC1656718

Physical and Histologic Properties of Substitutes Used for the Anterior Fossa Region Dural Repair

Abstract

During the last 10 years, 41 patients with dural tear caused by anterior cranial fossa bone fracture were treated surgically. Those treated conservatively were not included in this series. The patients' mean age was 36 years. The average time of postoperative observation was 15 months. Traffic accidents, as well as wounds caused by missiles (shell fragments or bullets), blows, and falls were the mechanisms of injury. An autogenous graft, followed by homologous (lyodura) and most recently by heterologous (lyoplant; B. Braun Melsungen AG, Melsungen, Germany) implants, was used to repair the dural lacerations. Fibrin adhesive was used to seal the sutures inserted between graft and dural defect margins in a majority of cases. The following criteria are required for the best dural substitute: uncontaminated tissue, histologic similarity to the local dura mater, adaptability, quick rehidratation, waterproof closure and the dural margins fast healing, and tensile strength easily resisting cerebrospinal fluid pressurization in physiological and pathological conditions. To define the effects of different tissue that could meet the above-mentioned criteria, we have undertaken a mechanical testing of the dural substitutes' tensile strength followed by histologic examination, and comparison with the dura mater of the anterior fossa region. Finally, we have paid particular attention to the clinical results of these substitutes.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Vranković D, Glavina K. Cranioplasty of the anterior fossa traumatic bone defect using autologous cancellous bone. Neurochirurgia (Stuttg) 1989 Jul;32(4):110–115. [PubMed]
  • Vranković D, Hećimović I, Splavski B, Dmitrović B. Management of missile wounds of the cerebral dura mater: experience with 69 cases. Neurochirurgia (Stuttg) 1992 Sep;35(5):150–155. [PubMed]
  • Greenblatt SH, Wilson DH. Persistent cerebrospinal fluid rhinorrhea treated by lumboperitoneal shunt. Technical note. J Neurosurg. 1973 Apr;38(4):524–526. [PubMed]
  • Jamieson KG, Yelland JD. Surgical repair of the anterior fossa because of rhinorrhea, aerocele, or meningitis. J Neurosurg. 1973 Sep;39(3):328–331. [PubMed]
  • Ray BS, Bergland RM. Cerebrospinal fluid fistula: clinical aspects, techniques of localization, and methods of closure. J Neurosurg. 1969 Apr;30(4):399–405. [PubMed]
  • Spetzler RF, Wilson CB. Management of recurrent CSF rhinorrhea of the middle and posterior fossa. J Neurosurg. 1978 Sep;49(3):393–397. [PubMed]
  • Ommaya AK, Di Chiro G, Baldwin M, Pennybacker JB. Non-traumatic cerebrospinal fluid rhinorrhoea. J Neurol Neurosurg Psychiatry. 1968 Jun;31(3):214–225. [PMC free article] [PubMed]
  • Schäfer M, Klein HJ, Richter HP. Fibrinkleber in der Neurochirurgie. Anwendungsgebiete und Erfahrungen. Fortschr Med. 1985 May 23;103(20):545–547. [PubMed]
  • Pomeranz S, Constantini S, Umansky F. The use of fibrin sealant in cerebrospinal fluid leakage. Neurochirurgia (Stuttg) 1991 Nov;34(6):166–169. [PubMed]
  • Brown P, Preece MA, Will RG. "Friendly fire" in medicine: hormones, homografts, and Creutzfeldt-Jakob disease. Lancet. 1992 Jul 4;340(8810):24–27. [PubMed]

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