The Application Of In Situ Bone Flap After Extended Endoscopic Transsphenoidal Approaches

Objective: To summarize the midterm outcome of patients with reconstruction of skull base after extended endoscopic transsphenoidal approaches(EETA)with in situ bone flap(ISBF)technique and explore the potentially related risk factors of ISBF healing.Materials and Methods: We retrospectively reviewed all patients undergone ISBF reconstruction of skull base after EETA in the First Affiliated Hospital of Chongqing Medical University from January 2016 to June 2020.The eligible patients were divided into two groups named Healing group and Non-healing group.Non-healing ISNF was defined as no osteo porosis or hypo porosis after 6 months follow-up.Clinical characteristics including age,gender,body mass index(BMI),smoking history and hypertension history were all collected and analyzed.And we compared the preoperatively variables including renal function indices,blood routine index and serum liver function variables to identify the potential risk factors.Results: Finally,we enrolled 72 patients with ISBF reconstruction of skull base.The mean age was 45.11±15.34.And their mean BMI was23.35±3.73.The male/female ratio was 33/39.In addition,only 24(33.33%)patients were with non-healing of ISBF.BMI of patients with healing ISBF was significantly lower than that of patients with non-healing ISBF,while the serum urea was statistically higher in the Healing group.The further logistic regression analyses also revealed lower BMI and higher serum urea were both beneficial for ISBF healing.Conclusions: BMI and serum urea might be predictive factors of ISBF healing.However,further and more specific studies are needed to explore the mechanisms.