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Reconstruction of the posterior wall of sphenoid sinus with a free bone graft after performing pituitary surgery
Introduction In the surgical treatment of skull base defects, various materials are used to reconstruct the anterior and middle skull base, e.g. Insertion of own fascia, fat, cartilage or bone. The use of free bone grafts in the anterior and middle skull base reconstruction is rarely published. The aim of this study is to investigate the use of free bone grafts in the reconstruction of the sphenoid sinus posterior wall after performing a pituitary surgery.
Material and patients Four patients with pituitary adenoma were treated endonasal, endoscopically for the resection of the pituitary adenoma interdisciplinary by the ENT clinic of Bethanien Hospital Plauen and the neurosurgical clinic of HELIOS Vogtland Clinic. In preparing the pituitary access, the bone material was recovered from the area of the sphenoid sinus anterior wall, the intra-sphenoid septum, and the posterior septal wall. This was prepared extracorporeal. At the end of the operation, a free bone graft was used to reconstruct the sphenoid sinus posterior wall and fixed using Tachosil. Computed tomography and magnetic resonance imaging were performed preoperatively and at least 6 months postoperatively to assess the free bone graft for reconstruction of the sphenoid sinus wall.
Results Four patients were treated between the ages of 36 - 71 years. There were no postoperative complications. At CT control at 6 months postoperatively, the bone graft was still present, stable and in good position
Summary The use of free bone graft after extracorporeal processing to cover and build the sphenoid sinus posterior wall is a good alternative to other free grafts such as fascia, abdominal fat or cartilage.
Article published online:
10 June 2020
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