Universität zu Köln

Grau, Stefan ORCID: 0000-0002-9742-527X, Kellermann, Stephanie, Faust, Michael, Perrech, Moritz, Beutner, Dirk, Drzezga, Alexander and Zoeller, Joachim (2018). Repair of Cerebrospinal Fluid Leakage Using a Transfrontal, Radial Adipofascial Flap: An Individual Approach Supported by Three-Dimensional Printing for Surgical Planning. World Neurosurg., 110. S. 315 - 319. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

BACKGROUND: Leakage of cerebrospinal fluid (CSF) because of large prolactinomas represents a complex issue. Because of limited anatomic space, multiple leakage sites, and scarce locally available tissue for repair, surgical possibilities are limited. We report an initial case of using a radial fasciocutaneous flap applied subfrontally to cover a large skull base defect, supported by preoperative three-dimensional (3D) printing for surgical planning. CASE DESCRIPTION: A 29-year-old woman developed severe nuchal pain that was caused by destruction of large parts of her skull base by a prolactinoma. After occipitocervical fusion, medical treatment showed good tumor response but led to CSF leakage after 12 months. An endoscopic approach and ventriculoperitoneal shunt implantation failed to stop the leakage. A 3D model of the skull improved the understanding of the expanded osseous destruction and multiple CSF leakage sites and supported surgical planning. For an extensive coverage of the former clivus and sella region, an intracranially applied radial flap was planned. Dopamine-agonist medication was increased before the operation. Intraoperatively, the flap was brought into position subchiasmatically and wound around the pituitary stalk. CSF leakage was not observed on follow-up (10 weeks). Long-term follow-up will determine the effectiveness of this method.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Grau, Stefan UNSPECIFIED orcid.org/0000-0002-9742-527X UNSPECIFIED Kellermann, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Faust, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Perrech, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Beutner, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Drzezga, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoeller, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-197526
DOI:	10.1016/j.wneu.2017.11.083
Journal or Publication Title:	World Neurosurg.
Volume:	110
Page Range:	S. 315 - 319
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SKULL BASE; RECONSTRUCTION; DEFECTS Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19752