Grafting materials in skull base reconstruction.

Area of Science:

• Neurosurgery
• Otolaryngology
• Biomaterials Science

Background:

• Endoscopic skull base surgery utilizes various grafting materials for repair.
• Graft options include autologous tissue, acellular human dermis, engineered collagen, rigid supports, and tissue glues.

Purpose of the Study:

• To review and categorize available graft materials for endoscopic skull base repair.
• To discuss the evidence supporting the use of different grafting materials.
• To provide guidance on selecting appropriate materials based on case characteristics.

Main Methods:

• Literature review and categorization of grafting materials.
• Analysis of evidence for commonly used sealants and graft types.
• Discussion of factors influencing material selection.

Main Results:

• Autologous tissues are common due to safety, availability, and cost.
• Engineered collagen and acellular dermis are suitable for revision or larger repairs.
• The necessity of rigid support is debated, with increasing use of pedicled grafts for large defects.
• Tissue glues and sealants are widely employed, with their components and evidence detailed.

Conclusions:

• Limited high-quality comparative evidence exists for graft material selection.
• Excellent outcomes are achievable with most materials when surgeon experience and patient factors are considered.
• Careful consideration of graft properties and clinical context is essential for successful endoscopic skull base repair.