Non-Watertight Intermittent Dural Closure in Neurological Surgery

뇌수술의 비방수성 경막 봉합

  • Cho, Yong Woon (Department of Neurosurgery, Kosin University Gospel Hospital) ;
  • Moon, Jae Gon (Hallym University Kang-Nam Sacred Heart Hospital) ;
  • Hwang, Yong Soon (Inje University Sanggye Paik Hospital) ;
  • Park, In Suk (Department of Neurosurgery, Kosin University Gospel Hospital) ;
  • Jeon, Byung Chan (Department of Neurosurgery, Kosin University Gospel Hospital) ;
  • Kim, Han Kyu (Department of Neurosurgery, Kosin University Gospel Hospital)
  • 조용운 (고신대학교 복음병원) ;
  • 문재곤 (한림대학교 의과대학 강남성심병원) ;
  • 황용순 (인제대학교 의과대학 상계백병원 신경외과학교실) ;
  • 박인석 (고신대학교 복음병원) ;
  • 전병찬 (고신대학교 복음병원) ;
  • 김한규 (고신대학교 복음병원)
  • Received : 1999.07.13
  • Accepted : 1999.12.02
  • Published : 2000.05.28

Abstract

Objective : In neurosurgical practice, it has been generally accepted that when the dura is opened, it should be watertightly closed, and traditionally non-watertight closure has not been performed. We clinically tried non-watertight closure, analyzed the frequency of CSF leakage and evaluated the possible clinical application of non-watertight closure. Methods : After classifying our cases with supratentorial and infratentorial approach, we tried non-watertight and watertight closures and compared the results. We also analyzed the cases with or without dural graft. Results : In supratentorial approach, the rate of cerebrospinal fluid leakage noted in non-watertight closure was similar to that of watertight closure. In infratentorial approach, except microvascular decompression(MVD), the rate of cerebrospinal fluid leakage in non-watertight closure was higher than that of watertight closure. Dura graft application did not seemed to influence the cerebrospinal fluid leakage. Conclusion : Since the frequency of cerebrospinal fluid leakage was not higher in non-watertight closure than that of watertight closure, non-watertight closure can be applied in supratentorial approach. In infratentorial approach, non-watertight closure may be applied in surgery with relatively short dural incision, such as MVD. However, non-watertight closure doesn't seem to be appropriate in surgery that requires wide dural incision, such as skull base surgery.

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