Volume 11,Issue 5
A Prospective Cohort Study on Biodegradable Polylactic Acid Occlusion Material-Assisted Endoscopic Skull Base Dural Defect Repair for Cerebrospinal Fluid Leak and Skull Base Bone Remodeling
Objective: To evaluate the efficacy of biodegradable polylactic acid (PLA) occlusion material-assisted endoscopic skull base dural defect repair on postoperative cerebrospinal fluid (CSF) leak incidence and skull base bone remodeling. Methods: A prospective cohort study design was employed. Patients undergoing endoscopic endonasal skull base dural defect repair in the Neurosurgery Department of a tertiary hospital from June 2023 to December 2025 were enrolled. They were divided into a study group (PLA occlusion material-assisted repair) and a control group (autologous material repair). The primary outcome was postoperative CSF leak incidence. Secondary outcomes included skull base bone defect area, bone mineral density, and intracranial infection rate at 6 months postoperatively. Results: A total of 164 patients were included (84 in the study group, 80 in the control group). The postoperative CSF leak rate in the study group was 3.6%, significantly lower than 12.5% in the control group (p = 0.038). CT evaluation at 6 months postoperatively showed that the study group had a superior reduction rate of skull base bone defect area and an increase in bone mineral density compared to the control group. Differences in bone volume fraction and trabecular thickness were statistically significant (p < 0.01). Intracranial infection rates were 1.2% and 6.3%, respectively (p = 0.086). Conclusion: Biodegradable PLA occlusion material-assisted endoscopic skull base repair effectively reduces postoperative CSF leak incidence and promotes skull base bone remodeling, representing a safe and effective repair strategy.
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