2025 Proffered Presentations
S017: TEMPORALIS MUSCLE FASCIA FREE GRAFT IN RECONSTRUCTION FOLLOWING RESECTION OF MALIGNANT CRANIAL BASE TUMORS
Martin Jurlina, PhD; Clinical Hospital Dubrava, Zagreb, Croatia
Background: Reconstruction of postablative cranial base defect after resection of malignant tumors represents a real technical challenge, especially in the region of anterior cranial base. Clinical experience with the exclusive use of free temporalis muscle fascia graft (FTMFG) in cranial base reconstruction following resection of malignant cranial base tumors will be presented. Both, open and endonasal endoscopic surgical techniques are to be outlined and described in detail.
Patients and methods: Data from patients with post-ablative dural defects reconstructed using a free temporalis muscle fascia graft (FTFG) after resection of anterior or central skull base tumors were retrospectively analyzed. The reconstructive methods for dural repair and postoperative cerebrospinal fluid (CSF) leak (- age rate) were respectively used as primary predictors and outcome variables to asses the quality of reconstruction.
Results: Eighty patients with anterior and central cranial base malignancies were included, and in all, 94 postoperative dural reconstructions were performed using FTFG. The postoperative CSF leakage rate was 3.19%. All CSF leakage stopped spontaneously within 48 hours after surgery and there were no revision surgeries after initial reconstruction. The postoperative CSF leakage rates did not significantly differ between open and endoscopic endonasal surgeries (1.92% vs. 4.88%; p > 0.05). In cases completed using the endonasal endoscopic approach, the postoperative CSF leakage rate was significantly associated with the intraoperative CSF leak flow (p < 0.05).
Conclusions: Our results suggest that the reconstruction of the most demanding post-ablative dural defect after resection of malignant cranial base tumpors using FTFG resulted in low postoperative CSF leakage and complication rates. These rates were better than those for the cranial base reconstruction using free fascia lata graft published in available literature, which makes FTFG a possible candidate for the material of choice in cranial base reconstruction, especially for endoscopic endonasal surgical technique.