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Related Experiment Video

Updated: Apr 17, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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Fascia patchwork closure for endoscopic endonasal skull base surgery.

Yudo Ishii1, Shigeyuki Tahara, Yujiro Hattori

  • 1Department of Neurosurgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, 173-8605, Japan, yudo@nms.ac.jp.

Neurosurgical Review
|February 14, 2015
PubMed
Summary

A new fascia patchwork closure technique effectively prevents cerebrospinal fluid (CSF) leakage after endoscopic endonasal skull base (EESB) surgery. This method may also improve postoperative nasal function, even without a nasoseptal flap.

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Endoscopic Skull Base Surgery

Background:

  • Endoscopic endonasal skull base (EESB) approaches are increasingly used for midline skull base tumors.
  • Postoperative cerebrospinal fluid (CSF) leakage is a known complication of EESB approaches.
  • The nasoseptal flap (NSF), while reducing CSF leakage, can impair nasal function.

Purpose of the Study:

  • To introduce and evaluate a novel "fascia patchwork closure" technique for EESB surgery.
  • To assess the efficacy of this technique in preventing CSF leakage.
  • To determine if the technique can reduce reliance on the nasoseptal flap (NSF) and preserve nasal function.

Main Methods:

  • Retrospective analysis of 48 patients undergoing midline skull base tumor resection via EESB.

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  • Application of the "fascia patchwork closure" technique in 32 of these cases.
  • Evaluation of CSF leakage incidence and assessment of nasal function post-surgery.

    • Main Results:

    • No incidence of CSF leakage was observed in the 32 cases using the fascia patchwork closure technique.
    • Six of these cases were successfully closed without the use of an NSF.
    • The technique proved effective as part of a multilayer closure for CSF leak prevention.

    Conclusions:

    • The fascia patchwork closure technique is a safe and effective method for preventing CSF leakage after EESB surgery.
    • This technique offers a promising alternative that may reduce the need for NSF, thereby preserving nasal function.
    • Wider adoption of this technique could advance EESB surgery and improve patient outcomes.