Abstract
Objectives This article aims (1) to determine whether there is any difference in cerebrospinal
fluid (CSF) leak rate after anterior skull base autologous fat reconstruction based
on how the fat is prepared, and (2) to measure impact on surgical times by reconstruction
type.
Design Translational animal model surgical technique 3-arm trial, comparing two different
methods of autologous fat skull base reconstruction versus a nonreconstructed control
group.
Setting Animal study.
Subjects Adult Sprague-Dawley rats.
Main Outcome Measures Resolution of CSF rhinorrhea after repair of a surgically created anterior skull
base defect.
Results Both wet (uncompressed) and dry (compressed) fat reconstruction of an anterior skull
base defect demonstrated lower CSF leak rates than nonreconstructed defects. Dry fat
reconstruction achieved significance in superiority of controlling CSF leak over no
reconstruction (64% success vs. 31%); while wet fat reconstruction trended toward
significance (50% vs. 31%). Reconstruction procedure time was longer than nonreconstructed
controls, but there was no significant difference between type of fat preparation
in surgical time.
Conclusions This study demonstrates that drying and compressing the fat graft improves autologous
fat reconstruction success for anterior skull base defects, and does not add significantly
to surgical time over nonprepared fat.
Keywords
autologous fat graft - cerebrospinal fluid leak - anterior skull base - skull base
reconstruction
