J Korean Neurosurg Soc.  2011 Dec;50(6):503-506. 10.3340/jkns.2011.50.6.503.

Clinical Efficacy of Radiation-Sterilized Allografts for Sellar Reconstruction after Transsphenoidal Surgery

• Kim S
• Jeon C
• Kong DS
• Park K
• Kim JH

• KMID: 2066899
• DOI: http://doi.org/10.3340/jkns.2011.50.6.503

Abstract

OBJECTIVE
The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery.
METHODS
Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at -70degrees C.
RESULTS
The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion.
CONCLUSION
We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.

Keyword

Endoscopic endonasal approach; Transsphenoidal approach; Allograft; Sellar reconstruction; CSF leak

MeSH Terms

Anti-Bacterial Agents
Cadaver
Fascia Lata
Follow-Up Studies
Humans
Mass Screening
Meningitis
Skull Base
Tissue Banks
Tissue Donors
Transplantation, Homologous
Transplants
Wound Infection
Anti-Bacterial Agents