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CASE REPORT - CRANIOMAXILLOFACIAL SURGERY
Year : 2021  |  Volume : 11  |  Issue : 1  |  Page : 136-139

Management of large dural defect with CSF leak in hypertelorism correction


1 Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India
2 Department of Neurosurgery, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. S M Balaji
Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, 30, KB Dasan Road, Teynampet, Chennai - 600 018, Tamil Nadu
India
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DOI: 10.4103/ams.ams_43_21

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The Rationale: Dural tear is a serious complication during hypertelorism corrective surgeries. Identifying the tear and managing requires considerable expertise. Managing large dural tears correctly is necessary to prevent cerebrospinal fluid (CSF)-related complications in craniofacial surgery. Patient Concerns: The patient presented with hypertelorism as a part of the Tessier Cleft 0 and sought to correct the widely placed eyes. Diagnosis: Large critical-sized dural tear during modified box osteotomy surgery. Treatment: Besides successful modified box osteotomy surgery, the critical-sized dural tear was managed with fascia lata and fibrin glue. Outcomes: There was no CSF leak or related complication postsurgically indicating successful sealing and healing of the dural tear. Take-Away Lessons: The synergistic mechanism by which fascia lata graft and fibrin glue help to hermetically seal the critical-sized defect, especially when there are variable amounts of hydrostatic-hydrodynamic forces of CSF exerting pressure on the patched area, is discussed.


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