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J Neurol Surg B Skull Base 2020; 81(01): 008-014
DOI: 10.1055/s-0039-1678602
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Bone Sandwich Closure Technique for Posterior Fossa Craniectomy

Shyam Sundar Krishnan
1   Achantha Lakshmipathi Neurosurgical Centre, Voluntary Health Services, Chennai, Tamil Nadu, India
,
Pulak Nigam
1   Achantha Lakshmipathi Neurosurgical Centre, Voluntary Health Services, Chennai, Tamil Nadu, India
,
Adarsh Manuel
1   Achantha Lakshmipathi Neurosurgical Centre, Voluntary Health Services, Chennai, Tamil Nadu, India
,
Madabushi Chakravarthy Vasudevan
1   Achantha Lakshmipathi Neurosurgical Centre, Voluntary Health Services, Chennai, Tamil Nadu, India
› Author Affiliations Funding No funding was received for this research.
Further Information

Publication History

18 August 2018

07 January 2019

Publication Date:
04 February 2019 (online)

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Abstract

Background Surgery of posterior fossa including cerebellopontine (CP) angle involves either craniectomy or craniotomy. While there has been precedence of craniotomy in recent practice, the preferred access in resource-strapped centers still remains been craniectomy. Although the latter offers an excellent exposure, it is believed to carry increased risk of postoperative pseudomeningocoele and cerebrospinal fluid (CSF) leak compared with craniotomy.

Methods We have suggested a technique by which after standard craniectomy for the posterior fossa surgeries the bony defect is covered by Gelfoam bone sandwich (GBS) technique. We studied this technique over a period of 25.6 years in 1,028 patients.

Results and Conclusion We analyze the risk of pseudomeningocoele and CSF leak in our patients using GBS technique and reviewed literature to compare our outcomes with standard craniotomy and craniectomy procedures.

Keywords

posterior fossa - bone sandwich - CSF leak - pseudomeningocoele - craniectomy

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


For this type of study, formal consent is not required.


 

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