Dural Closure Method Using Dural Suture and Polyglycolic Acid Nonwoven Fabric in the Endoscopic Endonasal Approach

Area of Science:

• Neurosurgery
• Skull Base Surgery
• Minimally Invasive Procedures

Background:

• Endoscopic endonasal approach (EEA) for sella turcica and parasellar tumors is expanding.
• Increasing use of EEA correlates with a higher risk of cerebrospinal fluid (CSF) leakage.
• Safe and effective reconstruction methods are crucial for preventing postoperative CSF leakage.

Purpose of the Study:

• To evaluate the efficacy of the simple and robust suture and polyglycolic acid (S-PGA) method for sella turcica reconstruction.
• To compare the incidence of CSF leakage between the S-PGA method and traditional fat-filling reconstructive procedures.

Main Methods:

• Retrospective analysis of 325 patients undergoing EEA with sella turcica reconstruction.
• Utilized the S-PGA method for dural closure in the study group.
• Compared outcomes with a historical cohort that underwent fat-based reconstruction.

Main Results:

• The S-PGA method demonstrated a significantly lower incidence of postoperative CSF leakage (0.8%) compared to the fat-filling method (5.2%) (P < 0.01).
• The S-PGA method did not interfere with postoperative MRI interpretation.
• No intrasellar fat filling was present with the S-PGA method, simplifying imaging analysis.

Conclusions:

• The S-PGA method is a simple, reliable technique for minimizing CSF leakage risk in EEA.
• This method represents an excellent option for skull base reconstruction.
• The S-PGA technique enhances surgical safety and improves patient outcomes in complex cranial base surgeries.