Our objective is to assess the autologous fat graft outcomes to endoscopically repair anterior skull base defects at a single tertiary care center.

All patients, who underwent endoscopic skull base repair utilizing abdominal free fat, were included for retrospective chart review. Evaluated outcome measurements successfully closed preoperative and intraoperative CSF leaks and complications at both donor and recipient graft sites during the postoperative periods. Four representative clinical cases have been selected to highlight the common indications for which the fat graft may be useful in skull base reconstruction.

Of the 27 patients identified for inclusion in this review, 25 demonstrated successful repair of preoperative or intraoperative CSF leaks following primary skull base repair. Two patients developed recurrent CSF leaks occurring about one week after their immediate closures, and a secondary closure rate of 96.3% was achieved with the use of fat grafts. Other complications included seroma and hematoma formation at the abdominal donor sites, each occurring in 1 patient.

The study concluded that the use of autologous fat remains a viable option for grafting material during endoscopic skull base reconstruction. Despite the wide variety of closure techniques in skull base surgery, autologous fat provides safe and easily accessible material to repair CSF leaks.

Reference: https://journals.sagepub.com/doi/full/10.1177/1945892418773637