Beyin omurilik sıvısı rinoresi onanını: Tavşan modelinde insan temporal fasyası, dura mater ve otolog kas fasyası ile greftlemenin histopatalojik bulgularının karşılaştırılması

Amaç: Transnazal yaklaşımla beyin omurilik sıvısı rinoresi onarımını değerlendirmek amacıyla, tavşanda insantemporal fasyası ile dura mater greftleriyle onarımın histopatolojik bulguları değerlendirildi.Çalışma Planı: Otuz iki tavşan kullanılan grefte göre üçgruba ayrıldı: İnsan dura materi, insan temporal fasyası veotolog kas fasyası kontrol grubu . Cerrahi olarak yaratılanaçıklığın onarımı için transnazal yaklaşım uygulandı. Kontrol grubu denekleri 1, 2, 3, 4. haftalarda; insan dura materi kullanılan denekler 1, 2, 3, 4, 32 ve 40. haftalarda; insantemporal fasyası kullanılan denekler 4, 32 ve 40. haftalarda öldürülerek iyileşme ile ilgili histopatolojik bulgular değerlendirildi.Bulgular: Hiçbir grupta makroskobik olarak serebral kortekse yapışıklık gözlenmedi. Kontrol grubunda yara iyileşmesi histolojik düzeyde dört haftada tamamlandı. Kadavrainsan greftleri ile tedavi edilen her iki grupta ise iyileşmesüreci kontrol grubuna göre daha uzun sürede tamamlandı. Bu iki grupta dördüncü haftada en belirgin bulgu geç biratılım reaksiyonuna işaret edebilecek olan dev hücrelerinvarlığı idi; ancak bu hücreler 32 ve 40. haftalarda tam biriyileşmeyle kayboldu. İyileşme sürecinin uzamasına rağmen klinik bir yan etki gözlenmedi.Sonuç: Bu deneysel model BOS rinoresi onarımında insan temporal fasyasının dura mater yerine kullanılabileceğini gösterdi

Anahtar Kelimeler:

Beyin-omurilik sıvısı rinoresi/cerrahi, hastalıkmodeli, hayvan, dura mater/cerrahi/transplantasyon, fistül/cerrahi, greft yaşaması, tavşan

The repair of cerebrospinal fluid rhinorrhea: comparison of histopathologic findings with cadaveric human temporal fascia, dura mater, and autologous fascia in a rabbit model

Objectives: To evaluate the repair of cerebrospinal fluid rhinorrhea through the transnasal approach, we investi- gated histopathologic findings of grafting with human tem- poralis fascia and dura mater in a rabbit model.Design and Methods: Thirty-two rabbits were assigned to three groups according to the graft material to be used: human dura mater, human temporalis fascia, and autologous muscle fascia control group . The repair of the surgically induced bony opening was performed via the transnasal approach. To eval uate healing process histopathologically, decapitation was per formed at the end of 1,2, 3, and 4 weeks in the control group; 1,2, 3, 4, 32 and 40 weeks in the dura mater group; 4, 32 and 40 weeks in the temporalis fascia group.Results: Macroscopically, adhesions to the cerebral cor- tex were not observed with any of the grafts.Histopathologically, complete healing occurred in four weeks in the control group. Healing took longer in both cadaveric graft groups, in which formation of giant cells was the most prominent feature at the end of four weeks, suggesting a late rejection. Nevertheless, these cells dis- appeared and complete resolution was observed at the end of 32 and 40 weeks. Despite prolonged healing, no adverse clinical effects were observed.Conclusions: This experimental model showed that human temporalis fascia can be used instead of dura mater in the repair of cerebrospinal fluid rhinorrhea.

Keywords:

Cerebrospinal rhinorrhea/surgery, disease models, animal, dura mater/surgery/transplantation, fistula/surgery, graft survival, rabbits,

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