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Τρίτη 11 Μαΐου 2021

The effect of prior radiation on the success of ventral skull base reconstruction: A systematic review and meta-analysis

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Head Neck. 2021 May 11. doi: 10.1002/hed.26709. Online ahead of print.

ABSTRACT

The incidence of cerebrospinal fluid leak after ventral skull base reconstruction is a primary outcome of interest to skull base surgeons. Exposure to pre-operative radiation may put patients at an increased risk of skull base reconstructive failure. A systematic search identified studies which included patients receiving ventral skull base reconstruction in the setting of pre-operative radiation. A meta-analysis using a random effects model was conducted to estimate an odds ratio of cerebrospinal fluid (CSF) leak in patients exposed to pre-operative radiation. A meta-analysis of 13 studies demonstrated that the odds ratio of CSF leak was 1.73 (95% CI 0.98-3.05). The majority of studies (77%) used vascularized tissue grafts for reconstruction. We identified an increased incidence of CSF leak among patients undergoing ventral skull base reconstruction after prior r adiation therapy, although not of statistical significance. Skull base surgeons should exercise caution when planning reconstruction in this population.

PMID:33973680 | DOI:10.1002/hed.26709

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