Objectives: To evaluate a technique of multi-layered CSF repair following endonasal anterior skull base surgery using medpor graft.
Design: Retrospective review of consecutive case series from a single centre.
Subjects: 68 cases of repair of CSF leaks utilising medpor identified from a larger prospectively maintained database of endonasal endoscopic procedures at our centre.
Methods: Retrospective review of a database of consecutive anterior skull base cases from 2016-2022, and further data collection from electronic hospital records.
Results: During follow up there were 7 cases of post-op CSF leak (10.3%). There were no radiological complications, and no cases of medpor removal or extrusion. Rates of infection were low, there were 3 (4.4%) cases of confirmed bacterial meningitis within our cohort. The mean length of stay was 4.7 days (median 3 days), with 16 cases discharged on the first post-operative day.
Conclusions: Our experience of using medpor in anterior skull base reconstruction demonstrates that medpor is a readily available, easily handled, and reliable graft option with relatively low rates of infection and post-op CSF leak. Its use reduces the use of autologous graft materials and the associated donor site morbidity. Our long term follow up data further demonstrates the safety and efficacy of this technique.
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