Abstract
Objective To compare the use of porcine small intestinal submucosal grafts (SISG) and standard
autologous material (fascia) in prevention of cerebrospinal fluid (CSF) leak and pseudomeningocele
formation after translabyrinthine resection.
Setting Set at the tertiary skull base center.
Methods This is a retrospective chart review. After Institutional Review Board approval,
we performed a retrospective cohort study evaluating CSF leak in patients who underwent
resection of lateral skull base defects with multilayered reconstruction using either
fascia autograft or porcine SISGs. Demographics were summarized with descriptive statistics.
Logistic regression was used to compare autograft and xenograft cohorts in terms of
CSF complications.
Results Seventy-seven patients underwent lateral skull base resection, followed by reconstruction
of the posterior cranial fossa. Of these patients, 21 (27.3%) underwent multilayer
repair using SISG xenograft. There were no significant differences in leak-associated
complications between autograft and xenograft cohorts. Ventriculoperitoneal shunt
was necessary in one (1.8%) autograft and one (4.8) xenograft cases (p = 0.49). Operative repair to revise surgical defect was necessary in three (5.4%)
autograft cases and none in xenograft cases.
Conclusion The use of SISG as a component of complex skull base reconstruction after translabyrinthine
tumor resection may help reduce CSF leak rates and need for further intervention.
Keywords
submucosal graft - xenograft - cerebrospinal fluid leak - craniotomy
