<< Back to the abstract archive
Autologous Fasciae for Dura Reconstruction: Systematic Review
Abdulaziz Elemosho MD, Emily Pfahl BS, Jude Kluemper BS, Kerry-Ann Mitchell MD-PhD
The Ohio State University
2024-01-15
Presenter: Abdulaziz Elemosho MD
Affidavit:
I certify that the work presented here is the original work of Zed and other members of the Mitchell Lab. And this work has not been presented at any other meeting.
Director Name: Gregory Pearson MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction:
Patients undergoing cranioplasty reconstruction with alloplastic cranial implants for acquired skull defects may encounter complications such as cerebrospinal fluid (CSF) leaks, durotomies, and infections. Duraplasty using xenografts, a common practice, is associated with increased infection risk and additional costs for patients. This study focuses on the established method of using autologous fascia for dural reconstruction, sourced from various donor sites like tensor fascia lata (TFL), galea-pericranium, rectus abdominis fascia, and cervical fasciae. This approach aims to mitigate complications observed with xenograft reconstruction, particularly in settings where cost-effective alternatives are crucial.
Methods:
A systematic literature review was conducted across major databases, resulting in 461 patients from 10 relevant articles (case series and cohort studies) meeting the inclusion criteria.
Results:
Among the patients, 185 (40.1%) underwent duraplasty with galea-pericranium, while 52 (11.3%) had TFL duraplasty without recorded postoperative complications. Notably, 26 patients (5.6%) with a prior xenograft infection underwent reoperation with TFL replacement. Duraplasty using cervical fascia was performed in 218 patients (47.3%) after posterior fossa tumor resection, and 6 patients (1.3%) used anterior rectus fascia (ARF) for large skull defects. No postoperative CSF leaks or infections were reported.
Conclusion:
Autologous fascia emerges as a cost-effective option for dural closure in neurosurgical procedures, outperforming xenografts or synthetic dura due to its lower infection risk and preserved vascular supply. This method presents a valuable opportunity, particularly in resource-limited settings where affordable alternatives are imperative.
