Repair of Dural Defects of the Anterior Skull Base Using Titanium Microclips

Background: Repairing injuries to the anterior skull base have presented challenges because of the limited workspace available in this area. Dural defects must be repaired to prevent cerebrospinal fluid leak with its resultant complications.

Objective: Analysis of the use of titanium microclips to repair difficult to access areas of the anterior skull base in patients who present with trauma of the frontal sinuses and anterior skull base.

Methods: This is a retrospective review of eight consecutive trauma patients with anterior skull base dural defects that were treated using titanium microclips between the years of 2016 and 2018. Details of the patient presentation, surgical approaches and dural repairs are presented. Patients were monitored postoperatively for complications secondary to cerebrospinal fluid leak. Postoperative scans were ordered and placement of the titanium clips could be seen.

Results: Surgeons successfully implemented dural defect repair of the anterior skull base in eight trauma patients. No postoperative cerebrospinal fluid leak, infection or any other complications were noted during routine postoperative care and follow-up. CT scans verified fracture repair and showed placement of the titanium clips without significant artifact.

Conclusion: Due to the limited workspace within the anterior skull base, dural repair is easier, more efficient, and effective when using titanium microclips compared with traditional repair techniques. This allows for potentially shorter operative times which exposes the patient to shorter anesthetic time and potentially fewer associated complications.