Efficiency and Safety of Autologous Fat Grafts in Reconstructing Skull Base Defects After Resection of Skull Base Meningiomas

Publication date: February 2018
Source:World Neurosurgery, Volume 110
Author(s): Hussam Metwali, Venelin Gerganov, Breno Nery, Ahmed Aly, Rodrigo Avila-Cervantes, Madjid Samii
BackgroundReconstruction of the skull base after resection of skull base meningiomas is of paramount importance. Here we describe a safe and effective method of skull base reconstruction using autologous free fat grafts.MethodsIn this retrospective analysis of patients operated for skull base meningioma from 2007 to 2014. We analyzed the surgical technique, efficiency and safety as well as the graft-related complications.ResultsAutologous free fat grafts were used in 55 patients, including 39 patients with posterior fossa meningiomas related to the petrous bone and 16 patients with anterior fossa meningiomas related to the paranasal sinuses. Three patients experienced postoperative cerebrospinal fluid (CSF) leak and were managed with temporary continuous lumbar drainage. One patient developed pneumocephalus and required revision. The occurrence of CSF leak was related to aggressive resection with resulting large skull base defects, especially in anterior skull base meningiomas. There were no donor site–related complications.ConclusionsThe use of autologous free fat grafts is an effective and safe technique for reconstructing skull base defects after microsurgical resection of skull base meningiomas.



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