Skull base reconstruction in endoscopic endonasal surgery using a novel nanofibrous synthetic dural patch

Reconstruction of the barriers between the intracranial space and the sinonasal tract continues to be a challenge after endoscopic endonasal skull base surgery. The gold standard is a multilayer closure that reproduces the physiological tissue barrier; a watertight closure is the paramount to prevent cerebrospinal fluid leak and meningitis. An effective dural closure may be achieved with a patch that satisfies the requirement of non-immune, neither inflammatory response or toxicity, improvement of dura regeneration, dura-like elasticity and resistance, easy handling and manageability. METHODS: In our paper we present and discuss our experience with a novel dural substitute, Re Dura (Medprin Biotech, La Mirada, CA, USA), for skull base reconstruction on 22 patients who underwent endoscopic endonasal removal of sellar and suprasellar lesions, with a minimum follow up of 14 months. RESULTS: All patients underwent endonasal endoscopic ENT evaluation after surgery. The otorinolaryngological assessment ruled out the absence of rhinorrhea and confirmed a physiological healing of the surgical scar. CONCLUSIONS: Based on our experience, we believe that the use of Re Dura PLLA mesh along with a multilayer reconstruction accomplished, when needed, with a mucosal flap, provides an effective combination for endonasal approaches, even extended ones.