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Journal of Korean Neurosurgical Society > Volume 50(6); 2011 > Article
Journal of Korean Neurosurgical Society 2011;50(6): 503-506.
doi: https://doi.org/10.3340/jkns.2011.50.6.503
Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery.
Sejin Kim, Chiman Jeon, Doo Sik Kong, Kwan Park, Jong Hyun Kim
1Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea.
2Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea.
3Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kds026@skku.edu
ABSTRACT
OBJECTIVE:
The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery.
METHODS:
Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at -70degrees C.
RESULTS:
The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion.
CONCLUSION:
We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.
Key Words: Endoscopic endonasal approach; Transsphenoidal approach; Allograft; Sellar reconstruction; CSF leak
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