Skull Base Dural Repair Using Autologous Fat as a Dural Substitute: An Efficient Technique

Area of Science:

• Neurosurgery
• Plastic and Reconstructive Surgery

Background:

• Skull base dural repair presents significant challenges, particularly with large defects.
• Autologous fat is emerging as a viable substitute for traditional dural repair materials.

Purpose of the Study:

• To evaluate the efficacy and safety of using autologous fat grafts for repairing substantial dural defects during skull base surgery.

Main Methods:

• A retrospective review of 71 patients undergoing skull base surgery with dural defects repaired by autologous fat grafts over 5 years.
• Grafts were harvested from the abdomen or thigh, flattened, and applied to dural defects.
• Clinical outcomes and complications were assessed.

Main Results:

• The most common pathologies were schwannomas (45%) and meningiomas (35.21%).
• Defects were primarily in the posterior (73.2%) and middle (25.4%) cranial fossae.
• No harvesting site complications occurred; 7 patients experienced transient fluid collection. No cerebrospinal fluid leaks or infections were reported.

Conclusions:

• Autologous fat grafting provides an effective and durable solution for dural repair in skull base surgery, even for extensive defects.
• The favorable outcomes and graft characteristics position autologous fat as an ideal dural substitute.