Collagen matrix as an inlay in endoscopic skull base reconstruction

J Laryngol Otol. 2018 Mar;132(3):214-223. doi: 10.1017/S0022215117001499. Epub 2017 Jul 18.

Abstract

Background: Multi-layer reconstruction has become standard in endoscopic skull base surgery. The inlay component used can vary among autografts, allografts, xenografts and synthetics, primarily based on surgeon preference. The short- and long-term outcomes of collagen matrix in skull base reconstruction are described.

Methods: A case series of patients who underwent endoscopic skull base reconstruction with collagen matrix inlay were assessed. Immediate peri-operative outcomes (cerebrospinal fluid leak, meningitis, ventriculitis, intracranial bleeding, epistaxis, seizures) and delayed complications (delayed healing, meningoencephalocele, prolapse of reconstruction, delayed cerebrospinal fluid leak, ascending meningitis) were examined.

Results: Of 120 patients (51.0 ± 17.5 years, 41.7 per cent female), peri-operative complications totalled 12.7 per cent (cerebrospinal fluid leak, 3.3 per cent; meningitis, 3.3 per cent; other intracranial infections, 2.5 per cent; intracranial bleeding, 1.7 per cent; epistaxis, 1.7 per cent; and seizures, 0 per cent). Delayed complications did not occur in any patients.

Conclusion: Collagen matrix is an effective inlay material. It provides robust long-term separation between sinus and cranial cavities, and avoids donor site morbidity, but carries additional cost.

Keywords: Collagen; Endoscopic Surgery; Skull Base.

MeSH terms

  • Adult
  • Aged
  • Cerebral Ventriculitis / epidemiology
  • Cerebrospinal Fluid Leak / epidemiology
  • Collagen*
  • Encephalocele / epidemiology
  • Endoscopy / methods*
  • Epistaxis / epidemiology
  • Female
  • Humans
  • Intracranial Hemorrhages / epidemiology
  • Male
  • Meningitis / epidemiology
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / epidemiology*
  • Postoperative Hemorrhage / epidemiology
  • Retrospective Studies
  • Seizures / epidemiology
  • Skull Base / surgery*
  • Surgical Flaps
  • Surgical Wound Infection / epidemiology

Substances

  • Collagen