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Updated: Jan 15, 2026
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Simple rigid skull base reconstruction with resorbable unsintered hydroxyapatite/poly-l-lactide plate in endoscopic
Kittipit Manthawornsiri1,2, Hiroki Morisako1, Atsufumi Nagahama1
1Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Background:
Skull base reconstruction following an extended endoscopic endonasal approach (EEA) is essential for preventing postoperative CSF leakage. Despite recent advancements in surgical techniques and materials, CSF leakage remains a significant complication. This report presents a rigid reconstruction technique utilizing a resorbable unsintered hydroxyapatite/poly-l-lactide (u-HA/PLLA) plate to reduce postoperative CSF leakage.
Observations:
Between May 2024 and June 2025, this method was used in 10 cases of extended EEA involving high-flow intraoperative CSF leaks and bone defects more than 25 mm. Notably, no postoperative CSF leakage was observed following the introduction of the u-HA/PLLA plate.
Lessons:
This material offers a unique combination of flexibility and mechanical strength comparable to cortical bone, along with osteoconductivity and bioresorbability, while producing negligible interference on postoperative imaging. These properties make it a highly promising material for skull base reconstruction. https://thejns.org/doi/10.3171/CASE25544.
