Fredes Felipe, Pinto Jaime, Pinto Nelson, Rojas Pablo, Prevedello Daniel M, Carrau Ricardo L, Schmidt Thomas
Department of Otolaryngology-Head & Neck Surgery, Universidad de Concepción, Concepción, Chile.
Department of Neurosurgery, Universidad de Concepción, Concepción, Chile.
Int J Otolaryngol. 2017;2017:1231870. doi: 10.1155/2017/1231870. Epub 2017 Nov 16.
Reconstruction of surgical defects following cranial base surgery is challenging. Others have demonstrated that leukocyte-platelet-rich fibrin (L-PRF) stimulates tissue healing and bone regeneration. However, these studies have addressed mostly maxillofacial surgical wounds.
The objective of this study was to assess the possible adjuvant role of L-PRF in inducing neoossification of the surgical bone defect in anterior skull base surgery.
We identified patients who had undergone an endoscopic endonasal surgery of the anterior skull base in which L-PRF membranes were used for the reconstruction of the bone defect and who were followed up with postoperative CT scans. CT findings were then correlated with baseline scans and with the CT scans of a patient who had undergone imaging and histologic analysis after maxillofacial surgery in which L-PRF was used and in which we demonstrated bone formation.
Five patients fulfilled the inclusion criteria. In four patients, the CT scan demonstrated closure of the bony defect by neoosteogenesis; however, the bone appeared less dense than the surrounding normal bone. A comparison with the control patient yielded similar radiological features.
This case series suggests that L-PRF may induce bone healing and regeneration at the surgical site defect. Multi-institutional studies with a larger series of patients are required to confirm this possibility.
颅底手术后手术缺损的重建具有挑战性。其他人已证明富含白细胞-血小板纤维蛋白(L-PRF)可刺激组织愈合和骨再生。然而,这些研究主要针对颌面外科伤口。
本研究的目的是评估L-PRF在前颅底手术中诱导手术骨缺损新骨形成的可能辅助作用。
我们确定了接受前颅底鼻内镜手术的患者,术中使用L-PRF膜重建骨缺损,并对其进行术后CT扫描随访。然后将CT结果与基线扫描以及一名在颌面外科手术中使用L-PRF并经影像学和组织学分析证实有骨形成的患者的CT扫描结果进行对比。
五名患者符合纳入标准。四名患者的CT扫描显示骨缺损通过新骨形成而闭合;然而,新形成的骨密度低于周围正常骨。与对照患者相比,影像学特征相似。
该病例系列表明L-PRF可能诱导手术部位缺损处的骨愈合和再生。需要进行多机构、更大样本量患者的研究来证实这种可能性。