Quantification of Fat Graft Retention in the Translabyrinthine Approach Using Magnetic Resonance Imaging Volumetric...

Area of Science:

• Neurosurgery
• Plastic Surgery
• Regenerative Medicine

Background:

• Autologous free fat grafting is a common technique for mastoid defect obliteration following translabyrinthine craniotomy for lateral skull base tumor resection.
• Understanding fat graft viability and factors influencing its long-term success is crucial for optimizing patient outcomes.

Purpose of the Study:

• To characterize the long-term viability and volume changes of autologous free fat grafts used in mastoid obliteration.
• To identify clinical and patient factors affecting fat graft survival.
• To assess the impact of fat graft survival on patient outcomes after translabyrinthine approach surgery.

Main Methods:

• Retrospective chart review of 42 adult patients who underwent translabyrinthine craniotomy and received autologous abdominal fat grafts for mastoid defect obliteration.
• Postoperative follow-up included serial magnetic resonance imaging (MRI) scans to assess fat graft volume and retention over time.
• Statistical analysis, including multivariate regression, was performed to evaluate factors influencing graft survival and complication rates.

Main Results:

• Fat grafts exhibited a logarithmic decline in volume, reaching a steady state of approximately 35.5% retention after a mean of 24.96 months.
• The mean follow-up period was 31.6 months, with an average of 3.2 MRI scans per patient.
• No significant association was found between clinical factors, initial graft volume, or resorption rate and the incidence of cerebrospinal fluid (CSF) leak or pseudomeningocele formation.

Conclusions:

• Autologous abdominal free fat grafts demonstrate a predictable pattern of volume loss over approximately two years after mastoid obliteration.
• The long-term success and complication rates (CSF leak/pseudomeningocele) were not significantly influenced by the initial graft volume, resorption rate, or final graft volume.
• No analyzed clinical factors demonstrated a significant impact on fat graft retention over time in this patient cohort.