Long-term follow-up results of dural reconstruction without bone graft at an terior skull-base defects

To clarify whether it is necessary to reconstruct bone defects at the anterior s kull base Methods A long term follow up study of 50 patients with anterior skull base defects i n which the dura was reconstructed without bone grafts was conducted CT and MR I examinations were taken periodically after surgery Results The ordinates of the bone defects averaged 3 5?cm (range, 2-6?cm), and the ab scissas averaged 2 8?cm (range, 2-5?cm) The abscissas of the bone defects m easured 2-3?cm in 38 patients, 3-4?cm in 10 patients, and 4-5?cm in 2 patient s The follow up ranged from 3 months to 5 years (average, 2 years) Conclusions At normal intracranial pressure, if the dura mater is repaired properly at the s kull base defects and reinforced with a pedicled pericranial flap, encephalomen ingocele and cerebrospinal fluid (CSF) leakage can be prevented It may not be necessary to make free bone grafts when the size of the cranial base bone defect is smaller than 4?cm