Cranial base reconstruction after transsphenoidal surgery with bioabsorbable implants: Technical note

OBJECTIVE: Reconstruction of the cranial base is often necessary after tran ssphenoidal surgery to prevent the occurrence of cerebrospinal fluid rhinor rhea and to maintain anatomic integrity. In most cases, sellar packing (fat , muscle, gelatin sponge) may be supported by bone or cartilage harvested a t the time of surgery. The use of synthetic material, however, becomes desi rable in cases in which an autograft is not available. Low-molecular-weight : polylactide implants may serve as an effective alternative because they a pe immunologically inert, magnetic resonance imaging-compatible, and easily contoured to custom-fit a defect. METHODS AND RESULTS: MacroSorb (MacroPore, San Diego, CA) absorbable plates are made from amorphous 70:30 poly (L-lactide-co-D,L-lactide) polymers. Im plants are malleable at temperatures of 70 degreesC and solidify at room or body temperature; plates are resorbed in 18 months. CONCLUSION: Polylactide polymer implants are effective adjuncts in transsph enoidal surgery when cranial base reconstruction is necessary and when an e ndogenous osseous or cartilaginous graft is unavailable.