Dural reconstruction with fascia, titanium mesh, and bone screws: Technical note

Objective: After the resection of cranial base tumors, there may not be eno ugh free dural margin left for reconstruction after involved bone and dura have been removed. In such a situation, dural reconstruction becomes a prob lem. We propose a new technique of dural closure in such cases. Methods: A fascial graft is prepared from either fascia lata, abdominal fas cia, pericranium, or temporal fascia and is trimmed to a size slightly larg er than that of the dural defect. The fascial graft is placed over the dura l defect and affixed to the underlying bone with a piece of titanium mesh, titanium screws, or both. The graft is then reinforced with fibrin glue. Results: This method of dural reconstruction has been used in five patients with basal meningiomas. Three were in the petromastoid area, and two were in the planum-ethmoid area. None of these patients experienced postoperativ e cerebrospinal fluid leak, and none experienced any complications related to the reconstruction. Conclusion: This technique of dural reconstruction can be used in selected cases of basal tumors without enough free dural margin to sew into a fascia l graft.