Home > DARE Reviews > Endoscopic skull base reconstruction of...

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence

Review published: 2012.

Bibliographic details: Harvey RJ, Parmar P, Sacks R, Zanation AM.  Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence. Laryngoscope 2012; 122(2): 452-459. [PubMed: 22253060]

Abstract

OBJECTIVES/HYPOTHESIS: Systematically review the outcomes of endoscopic endonasal techniques to reconstruct large skull base defects (ESBR). Such surgical innovation is likely to be reported in case series, retrospective cohorts, or case-control studies rather than higher level evidence.

STUDY DESIGN: Systematic review and meta-analysis.

METHODS: Embase (1980-December 7, 2010) and MEDLINE (1950-November 14, 2010) were searched using a search strategy designed to include any publication on endoscopic endonasal reconstruction of the skull base. A title search selected those articles relevant to the clinical or basic science of an endoscopic approach. A subsequent abstract search selected articles of any defect other than simple cerebrospinal fluid (CSF) fistula, sella only, meningoceles, or simple case reports. The articles selected were subject to full-text review to extract data on perioperative outcomes for ESBR. Surgical technique was used for subgroup analysis.

RESULTS: There were 4,770 articles selected initially, and full-text analysis produced 38 studies with extractable data regarding ESBR. Of these articles, 12 described a vascularized reconstruction, 17 described free graft, and nine were mixed reconstructions. Three had mixed data in clearly defined patient groups that could be used for meta-analysis. The overall CSF leak rate was 11.5% (70/609). This was represented as a 15.6% leak rate (51/326) for free grafts and a 6.7% leak rate (19/283) for the vascularized reconstructions (χ(2) = 11.88, P = .001).

CONCLUSIONS: Current evidence suggests that ESBR with vascularized tissue is associated with a lower rate of CSF leaks compared to free tissue graft and is similar to reported closure rates in open surgical repair.

Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 22253060

PubMed Health Blog...

read all...

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...