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CASE REPORT article

Front. Surg.
Sec. Neurosurgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1436361

Case report: First Use of Dental Bisphenol A-Glycidyl Methacrylate (bis-GMA) Composite without UV Light Polymerization for Repair of Iatrogenic CSF leak following a Frontal Craniotomy plus Tumor Resection

Provisionally accepted
Haman Nassourou Oumarou Haman Nassourou Oumarou 1,2*Ndome Toto L.Orlane Ndome Toto L.Orlane 3
  • 1 University of Yaounde I, Yaounde, Cameroon
  • 2 Faculté de Médecine et des Sciences Biomédicales, Université de YaoundéI, Yaoundé, Centre, Cameroon
  • 3 Faculty of Medicine and Pharmaceutical Science, University of Douala, Douala, Cameroon

The final, formatted version of the article will be published soon.

    Objective: Evaluate the efficacy and safety of Bis-GMA without UV light polymerization for the repair of refractory iatrogenic CSF leaks with large skull base defects.Background: Cerebrospinal fluid (CSF) leakage remains a common complication after neurosurgical intervention with resultant substantial impact on morbidity and increased healthcare cost. The management of refractory CSF leaks with large skull base defects remains challenging. Radiological investigations are highly contributive as they visualise the defect and assess the herniated content. Optimal treatment depends on the breach parameters and the consequent hernia. Surgery, when indicated, consists of exposure of the defect and its reconstruction using different grafts. The dental composite bisphenol A glycidyl methacrylate (Bis-GMA) has been investigated and has shown effectiveness for the repair of anterior skull base defects. This is due to its compactible mechanical properties, long-term stability and good osteo-integration. Hence, it presents a promising solution for refractory CSF leaks not responding to extradural endoscopic techniques.Case Report: We describe the case of a 40-year-old female with persistent CSF rhinorrhoea following a left frontal craniotomy performed four years before. High resolution cerebral CT scan and MRI revealed a bilateral fronto-ethmoidal osteomeningeal breach and T2 hyperintense signal in the ethmoidal sinus interrupting the hypointensity of the bone respectively. In our patient, surgical treatment involved bifrontal craniotomy plus osteomeningeal reconstruction with the use Bis-GMA without UV light polymerization. This reconstruction gave rigid structural support and watertight closure of the defect. Postoperatively, the CSF rhinorrhoea ceased and there was no perceivable associated complication.Given the favourable outcome, the composite Bis-GMA without UV light polymerization can be used as a reliable material for the repair of iatrogenic CSF leaks.

    Keywords: Bis-GMA, CSF leak, reconstruction, osteo-meningeal breach, case report

    Received: 21 May 2024; Accepted: 17 Dec 2024.

    Copyright: © 2024 Oumarou and L.Orlane. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Haman Nassourou Oumarou, University of Yaounde I, Yaounde, Cameroon

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