gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

New model of bone reconstruction specially designed for skull base surgery. Long-term testing in primates

Neues Knochenrekonstruktionsmodell nach Schädelbasisoperationen-Langzeitstudie an Primaten

Meeting Abstract

  • corresponding author C. Charalampaki - Klinik für Neurochirurgie, Johannes Gutenberg-Universität Mainz
  • A. Heimann - Institut für Neurochirurgische Pathophysiologie, Johannes Gutenberg-Universität Mainz
  • L. Kopacz - Institut für Neurochirurgische Pathophysiologie, Johannes Gutenberg-Universität Mainz
  • A. Perneczky - Klinik für Neurochirurgie, Johannes Gutenberg-Universität Mainz
  • O. Kempski - Institut für Neurochirurgische Pathophysiologie, Johannes Gutenberg-Universität Mainz

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 103

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc358.shtml

Veröffentlicht: 11. April 2007

© 2007 Charalampaki et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The direct endonasal or transoral transclival approaches to the skull base permits effective minimally invasive surgery along the clivus region. Developing consistently effective techniques to prevent cerebrospinal fluid (CSF)-leaks and their consequences (infections and healing processes with long and complicated recoveries) remain a major challenge. In this study we tested a method of bone reconstruction newly developed by us, which makes use of a specially designed elastic silicone plug and can be used for bone replacement after minimally invasive skull base surgery without risks of postoperative CSF leaks.

Methods: After an acute testing of plug efficiency in a pig model, whose results showed a 100% closure of the bone defect without CSF-leak, we tested the long-term efficiency of the plugs in 3 primates. We used an endoscope-controlled transoral transclival approach and simulated a CSF-leakage after opening the dura. We inserted the plug into the bone defect and closed the mucosa of the oral cavity with stiches. The follow-up includes blood-, CSF-, weight-, and wound control 1, 4 and 8 weeks after operation. Social behavior such as reintegration and postoperative eating abnormalities were also studied. The target points of this study was to examine: 1) The biocompatibility of the material, 2) Development of infection against the foreign body, 3) Growth behavior of the plug on the surrounding bone, 4) Development of CSF-leakages in the early and late postoperative phase.

Results: Infection was not seen in CSF and blood testings. The wound healing was normal. The social behavior of the animals in the early postoperative phase and during the 2 months follow-up was excellent and without any eating or weight abnormalities. CSF leakages was not developed. The histological examination of the clivus bone showed no abnormalities.

Conclusions: This novel medical device allows an easy, fast and uncomplicated use. It enables leak-proof closure of bone defects after minimal invasive craniotomies like the transclival approach; no additional surgery or other therapies are necessary.