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Collagen matrix as an inlay in endoscopic skull base reconstruction

Published online by Cambridge University Press:  18 July 2017

G M Oakley ,
J M Christensen ,
M Winder ,
B P Jonker ,
A Davidson ,
T Steel ,
C Teo  and
R J Harvey
G M Oakley*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, USA Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia
J M Christensen
Affiliation:
Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia
M Winder
Affiliation:
Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia Department of Neurosurgery, St Vincent's Hospital, Sydney, Australia
B P Jonker
Affiliation:
Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia Department of Neurosurgery, St Vincent's Hospital, Sydney, Australia
A Davidson
Affiliation:
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
T Steel
Affiliation:
Department of Neurosurgery, St Vincent's Hospital, Sydney, Australia
C Teo
Affiliation:
Centre for Minimally Invasive Neurosurgery, Prince of Wales Hospital, Sydney, Australia
R J Harvey
Affiliation:
Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
*
Address for correspondence: Dr Gretchen M Oakley, 2233 Post St, 3rd Floor, Box 1225, San Francisco, CA 94117, USA Fax: +1 415 885 7546 E-mail: gmoakley@gmail.com
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Abstract

Background:

Multi-layer reconstruction has become standard in endoscopic skull base surgery. The inlay component used can vary among autografts, allografts, xenografts and synthetics, primarily based on surgeon preference. The short- and long-term outcomes of collagen matrix in skull base reconstruction are described.

Methods:

A case series of patients who underwent endoscopic skull base reconstruction with collagen matrix inlay were assessed. Immediate peri-operative outcomes (cerebrospinal fluid leak, meningitis, ventriculitis, intracranial bleeding, epistaxis, seizures) and delayed complications (delayed healing, meningoencephalocele, prolapse of reconstruction, delayed cerebrospinal fluid leak, ascending meningitis) were examined.

Results:

Of 120 patients (51.0 ± 17.5 years, 41.7 per cent female), peri-operative complications totalled 12.7 per cent (cerebrospinal fluid leak, 3.3 per cent; meningitis, 3.3 per cent; other intracranial infections, 2.5 per cent; intracranial bleeding, 1.7 per cent; epistaxis, 1.7 per cent; and seizures, 0 per cent). Delayed complications did not occur in any patients.

Conclusion:

Collagen matrix is an effective inlay material. It provides robust long-term separation between sinus and cranial cavities, and avoids donor site morbidity, but carries additional cost.

Keywords

Endoscopic SurgerySkull BaseCollagen

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 3 , March 2018 , pp. 214 - 223
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented as a poster at the Australian Society of Otolaryngology Head and Neck Surgery Annual Scientific Meeting, 6–8 March 2016, Melbourne, Victoria, Australia.

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