Purpose : Postoperative cerebrospinal fluid (CSF) leakage after neurosurgery could lead to potentially lethal complications. Reoperations, multiple operations, cranial radiotherapy and poor vascularization of the dura graft may lead to delayed healing of the suture site and resultant persistent CSF leaks. In this report, we present a technical experience of duroplasty with omental free flap. Methods : Between 2007 and 2011, the authors performed duraplasty in nine patients with recurrent subdural empyema and intracranial infection. The omental free flap transfer was intended for patients who could not be cured with conventional surgical debridement and lyophilized dura appliance. Patient ages ranged from 14 to 47 years (mean, 31.5 yr). There were five men and four women. Treatment was required for malignant tumors (n=4), cerebral hematomas (n=3) and the result of traumas (n=2). After harvesting the omentum laparoscopically, the flap was sutured to the dural defect in a watertight fashion. The most commonly used recipient vessels were the superficial temporal artery and vein. Results : The postoperative course was uneventful and flap survival was excellent in all patients. Cerebrospinal fluid leaks were controlled successfully. Patients were discharged with no evidence of wound discharge and there were no reports of infection or CSF leakage recurrence. Conclusion : Duraplasty using omental flap is an effective technique to control CSF leaks, especially when dura is poorly vascularized and less viable. The delicate nature and great pliability of the omental flap make it unique and competent for reconstructions of dural defects.
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