Graftless Primary Dural Closure Following Retrosigmoid Approach: Doing More With less

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dc.authorscopusidAbuzer Güngör / 54895233300
dc.authorwosidAbuzer Güngör / F-4189-2019
dc.contributor.authorÇavuşoğlu, Neslihan
dc.contributor.authorErol, Gökberk
dc.contributor.authorSevgi, Umut Tan
dc.contributor.authorBulgur, Feride
dc.contributor.authorDoğruel, Yücel
dc.contributor.authorLuzzi, Sabino
dc.contributor.authorGadol, Aaron A.Cohen
dc.contributor.authorGüngor, Abuzer
dc.date.accessioned2025-04-18T07:05:35Z
dc.date.available2025-04-18T07:05:35Z
dc.date.issued2024
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü
dc.description.abstractIntroduction: Achieving watertight dural closure without grafts via the retrosigmoid approach can be challenging, contributing to a significant rate of postoperative cerebrospinal fluid (CSF) leaks. This study describes a dural incision technique for achieving primary dural closure without grafts following the retrosigmoid approach and presents clinical data from the authors' experience. Methods: Clinical and surgical data of 227 patients who underwent the dural incision technique following the retrosigmoid approach for various pathologies were retrospectively reviewed. To achieve no-graft watertight dural closure, the dural incision involves 2 critical steps: a 1 cm transverse incision of the dura parallel to the foramen magnum to drain CSF from the cisterna magna, and a vertical linear opening of the retrosigmoid dura. Dural incisions were closed watertight with vicryl 4/0 running sutures, without the use of grafts, fibrin glue, hemostatic overlays, or dural substitutes. Pre- or postoperative lumbar drainage was not employed. Results: Primary watertight dural closure was successfully achieved in all patients without the use of grafts or duraplasty. The average duration of dura closure was 17.7 minutes. During an average follow-up period of 49.3 months, there were no instances of CSF leaks or meningitis. Conclusions: In the authors' preliminary experience, the linear dural incision described herein was effective for achieving a no-graft, watertight primary dural closure in the retrosigmoid approach, with no CSF leaks or meningitis in our series. Validation of these preliminary data in a larger patient cohort is necessary. © 2024 Elsevier Inc.
dc.identifier.citationÇavuşoğlu, N., Erol, G., Sevgi, U. T., Bulgur, F., Doğruel, Y., Luzzi, S., ... & Güngor, A. (2024). Graftless Primary Dural Closure Following Retrosigmoid Approach: Doing More With less. World Neurosurgery, 189, e1006-e1012.
dc.identifier.doi10.1016/j.wneu.2024.07.065
dc.identifier.endpagee1012
dc.identifier.issn18788750
dc.identifier.pmid39004178
dc.identifier.scopus2-s2.0-85200921894
dc.identifier.startpagee1006
dc.identifier.urihttp://dx.doi.org/10.1016/j.wneu.2024.07.065
dc.identifier.urihttps://hdl.handle.net/20.500.12713/6415
dc.identifier.volume189
dc.identifier.wosWOS:001311538300001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakScopus
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.institutionauthorGüngör, Abuzer
dc.institutionauthoridAbuzer Güngör / 0000-0002-2792-7610
dc.language.isoen
dc.publisherElsevier Inc.
dc.relation.ispartofWorld Neurosurgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectCSF Leak
dc.subjectMeningitis
dc.subjectNo-graft Technique
dc.subjectRetrosigmoid Approach
dc.subjectSurgical Outcomes
dc.subjectWatertight Closure
dc.titleGraftless Primary Dural Closure Following Retrosigmoid Approach: Doing More With less
dc.typeArticle

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