Application of Leukocyte and platelet-rich fibrin as a sealing material in endoscopic reconstruction of spontaneous CSF leaks

Abstract

Objective: Different materials are used to repair skull base defects. Free grafts such as nasal mucoperiosteum, fascia lata, fascia temporalis, and adipose tissue are commonly employed and have satisfactory results. However, free grafts, particularly extra-nasal tissues implanted overlay, are usually not entirely integrated, resulting in excessive nasal crusting and patient discomfort in the postoperative months. We attempted in our study to use Leukocyte- and platelet-rich fibrin (L-PRF) membranes in skull base defect reconstruction. Patients and Methods: This prospective controlled study was conducted on 42 patients with spontaneous CSF rhinorrhea who were randomly divided into 2 groups according to the materials used in skull base reconstruction. In group A, the defects were repaired by L-PRF membranes, fascia lata, and mucosal graft while fascia lata and mucosal graft were only used in group B. Results: There was no statistically significant difference between the two groups regarding the early CSF leak. On the other hand, there was a difference related to the postoperative sinonasal crusting which shows a statistical significance. Conclusion: L-PRF membrane was found to be a good sealing material in the repair of CSF leak as it encourages the healing of surrounding tissues and minimizes sinonasal morbidities such as severe crust formation.