Simple rigid skull base reconstruction with resorbable unsintered hydroxyapatite/poly-l-lactide plate in endoscopic endonasal skull base tumor surgery: illustrative case.

Journal of neurosurgery. Case lessons Pub Date : 2025-10-06 DOI:10.3171/CASE25544

Kittipit Manthawornsiri, Hiroki Morisako, Atsufumi Nagahama, Masaki Ikegami, Rayford Hazunga, Boon Seng Liew, Takeo Goto

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Abstract

Background: Skull base reconstruction following an extended endoscopic endonasal approach (EEA) is essential for preventing postoperative CSF leakage. Despite recent advancements in surgical techniques and materials, CSF leakage remains a significant complication. This report presents a rigid reconstruction technique utilizing a resorbable unsintered hydroxyapatite/poly-l-lactide (u-HA/PLLA) plate to reduce postoperative CSF leakage.

Observations: Between May 2024 and June 2025, this method was used in 10 cases of extended EEA involving high-flow intraoperative CSF leaks and bone defects more than 25 mm. Notably, no postoperative CSF leakage was observed following the introduction of the u-HA/PLLA plate.

Lessons: This material offers a unique combination of flexibility and mechanical strength comparable to cortical bone, along with osteoconductivity and bioresorbability, while producing negligible interference on postoperative imaging. These properties make it a highly promising material for skull base reconstruction. https://thejns.org/doi/10.3171/CASE25544.

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内镜下鼻内颅底肿瘤手术中采用可吸收的未烧结羟基磷灰石/聚l-丙交酯钢板重建简单刚性颅底：说明性病例。

背景：扩大内镜鼻内入路（EEA）后颅底重建是预防术后脑脊液漏的必要条件。尽管最近外科技术和材料的进步，脑脊液渗漏仍然是一个重要的并发症。本报告介绍了一种利用可吸收的未烧结羟基磷灰石/聚l-丙交酯（u-HA/PLLA）钢板的刚性重建技术，以减少术后脑脊液渗漏。观察：在2024年5月至2025年6月期间，该方法用于10例术中高流量脑脊液泄漏和大于25mm骨缺损的扩展性EEA。值得注意的是，引入u-HA/PLLA钢板后未观察到术后脑脊液漏。经验教训：这种材料提供了与皮质骨相当的柔韧性和机械强度的独特组合，同时具有骨导电性和生物可吸收性，同时对术后成像产生可忽略不计的干扰。这些特性使其成为一种非常有前途的颅底重建材料。https://thejns.org/doi/10.3171/CASE25544。

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来源期刊

Journal of neurosurgery. Case lessons

CiteScore

0.40

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0.00%

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