Endoscopic-assisted Duraplasty with Collagen Matrix for Growing Skull Fracture: A Case Report

Growing skull fracture (GSF) is a rare complication of pediatric head injury. Early diagnosis and immediate surgical intervention are required for the prevention of irreversible brain damage. Surgical management involves water-tight closure of the dural defect and commonly uses autologous materials...

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Autores principales: KOZAKI, Yuki, NONAKA, Masani, MIKI, Koichi, TANAKA, Hideaki, ABE, Hiroshi, INOUE, Tooru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769400/
https://www.ncbi.nlm.nih.gov/pubmed/35079464
http://dx.doi.org/10.2176/nmccrj.cr.2020-0174
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author KOZAKI, Yuki
NONAKA, Masani
MIKI, Koichi
TANAKA, Hideaki
ABE, Hiroshi
INOUE, Tooru
author_facet KOZAKI, Yuki
NONAKA, Masani
MIKI, Koichi
TANAKA, Hideaki
ABE, Hiroshi
INOUE, Tooru
author_sort KOZAKI, Yuki
collection PubMed
description Growing skull fracture (GSF) is a rare complication of pediatric head injury. Early diagnosis and immediate surgical intervention are required for the prevention of irreversible brain damage. Surgical management involves water-tight closure of the dural defect and commonly uses autologous materials because of tissue compatibility; however, a large skin flap and craniotomy are necessary to harvest the autologous materials and repair the dural defect. We describe a successful case of endoscopic-assisted duraplasty using collagen matrix in a female infant suffering from early phase GSF. A 4-month-old female infant presented with a GSF. We surgically treated her because the fracture width progressively expanded 6 days post-injury. A zigzag skin incision was made, and the extent of the skull fracture and dural laceration was observed using an endoscope. Utilizing the collagen matrix, duraplasty was performed to completely seal the dural defect. Subsequently, cranioplasty was performed and the opposite sides of the fracture margins were drawn and bonded by nylon suture. Postoperatively, the patient did not develop any complication or experience recurrence. This is the first report of duraplasty using collagen matrix in GSF, and the collagen matrix can be used as a dural substitute. This novel technique was safe and a less invasive surgical approach for treating patients with GSF.
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spelling pubmed-87694002022-01-24 Endoscopic-assisted Duraplasty with Collagen Matrix for Growing Skull Fracture: A Case Report KOZAKI, Yuki NONAKA, Masani MIKI, Koichi TANAKA, Hideaki ABE, Hiroshi INOUE, Tooru NMC Case Rep J Case Report Growing skull fracture (GSF) is a rare complication of pediatric head injury. Early diagnosis and immediate surgical intervention are required for the prevention of irreversible brain damage. Surgical management involves water-tight closure of the dural defect and commonly uses autologous materials because of tissue compatibility; however, a large skin flap and craniotomy are necessary to harvest the autologous materials and repair the dural defect. We describe a successful case of endoscopic-assisted duraplasty using collagen matrix in a female infant suffering from early phase GSF. A 4-month-old female infant presented with a GSF. We surgically treated her because the fracture width progressively expanded 6 days post-injury. A zigzag skin incision was made, and the extent of the skull fracture and dural laceration was observed using an endoscope. Utilizing the collagen matrix, duraplasty was performed to completely seal the dural defect. Subsequently, cranioplasty was performed and the opposite sides of the fracture margins were drawn and bonded by nylon suture. Postoperatively, the patient did not develop any complication or experience recurrence. This is the first report of duraplasty using collagen matrix in GSF, and the collagen matrix can be used as a dural substitute. This novel technique was safe and a less invasive surgical approach for treating patients with GSF. The Japan Neurosurgical Society 2021-06-10 /pmc/articles/PMC8769400/ /pubmed/35079464 http://dx.doi.org/10.2176/nmccrj.cr.2020-0174 Text en © 2021 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Case Report
KOZAKI, Yuki
NONAKA, Masani
MIKI, Koichi
TANAKA, Hideaki
ABE, Hiroshi
INOUE, Tooru
Endoscopic-assisted Duraplasty with Collagen Matrix for Growing Skull Fracture: A Case Report
title Endoscopic-assisted Duraplasty with Collagen Matrix for Growing Skull Fracture: A Case Report
title_full Endoscopic-assisted Duraplasty with Collagen Matrix for Growing Skull Fracture: A Case Report
title_fullStr Endoscopic-assisted Duraplasty with Collagen Matrix for Growing Skull Fracture: A Case Report
title_full_unstemmed Endoscopic-assisted Duraplasty with Collagen Matrix for Growing Skull Fracture: A Case Report
title_short Endoscopic-assisted Duraplasty with Collagen Matrix for Growing Skull Fracture: A Case Report
title_sort endoscopic-assisted duraplasty with collagen matrix for growing skull fracture: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8769400/
https://www.ncbi.nlm.nih.gov/pubmed/35079464
http://dx.doi.org/10.2176/nmccrj.cr.2020-0174
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