Porcine small intestine submucosal graft for endoscopic skull base reconstruction

Elisa Illing, Mohamad Chaaban, Kristen O. Riley, Bradford A. Woodworth

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Skull base defects and encephaloceles of the sinus and nasal cavities are routinely repaired endoscopically using a variety of materials including bone, cartilage, fascia, acellular dermal allografts, and xenografts, with high success rates. However, there is a paucity of data regarding the use of porcine small intestine submucosal (SIS) grafts for endoscopic dural repair. The purpose of the current study was to review outcomes using SIS grafts in the endoscopic reconstruction of skull base defects. Methods: Review of prospectively collected data regarding skull base defect repair using SIS was performed. Demographics, location, and size of skull base defect, method of repair, successful closure, and complications were recorded. Results: Over 4.5 years, 155 patients (mean age 49 years) underwent 170 primary skull base repairs using porcine SIS. Etiologies included tumor (76), spontaneous (51), trauma (37), and congenital (5). The majority of repairs were in combination with a nasoseptal flap (n = 113). Average defect size (length vs width) was 13 × 10.5 mm. Success rate on first attempt was 94.7% (161/170), and all defects were effectively sealed on subsequent endoscopic revision. The average follow-up was 77 weeks. Major postoperative complications, including recurrent cerebrospinal fluid (CSF) leak (9), meningitis (1), periorbital cellulitis (1), and invasive fungal sinusitis (1), occurred in 6.4% of individuals with no long-term sequelae. Conclusion: Use of porcine SIS dural graft was associated with excellent outcomes in this study and evidence presented here supports its routine use in the endoscopic closure of skull base defects.

Original languageEnglish (US)
Pages (from-to)928-932
Number of pages5
JournalInternational Forum of Allergy and Rhinology
Volume3
Issue number11
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Skull Base
Small Intestine
Swine
Transplants
Encephalocele
Cellulitis
Nasal Cavity
Fascia
Sinusitis
Meningitis
Heterografts
Cartilage
Allografts
Demography
Outcome Assessment (Health Care)
Bone and Bones
Skin
Wounds and Injuries
Neoplasms

Keywords

  • Acetazolamide
  • Cerebrospinal fluid leak
  • CSF leak repair
  • CSF rhinorrhea
  • Empty sella
  • Encephalocele
  • Endoscopic sinus surgery
  • Intracranial hypertension
  • Pseudotumor cerebri
  • Skull base defect
  • Spontaneous

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Porcine small intestine submucosal graft for endoscopic skull base reconstruction. / Illing, Elisa; Chaaban, Mohamad; Riley, Kristen O.; Woodworth, Bradford A.

In: International Forum of Allergy and Rhinology, Vol. 3, No. 11, 11.2013, p. 928-932.

Research output: Contribution to journalArticle

Illing, Elisa ; Chaaban, Mohamad ; Riley, Kristen O. ; Woodworth, Bradford A. / Porcine small intestine submucosal graft for endoscopic skull base reconstruction. In: International Forum of Allergy and Rhinology. 2013 ; Vol. 3, No. 11. pp. 928-932.
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