{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:01:14Z","timestamp":1783774874662,"version":"3.55.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The use of vascularized flap to reconstruct the skull base defects has dramatically changed the postoperative cerebrospinal fluid (CSF) leak rates allowing the expansion of endoscopic skull base procedures. At present, there is insufficient scientific evidence to permit identification of the optimal reconstruction technique after the endoscopic endonasal approach (EEA).<\/jats:p><jats:p>\n          Objective\u2003The main purpose of this article is to establish the risk factors for failure in the reconstruction after EEA and whether the use of a surgical reconstruction protocol can improve the surgical results.<\/jats:p><jats:p>\n          Material and Methods\u2003A retrospective cohort study was conducted in our institution, selecting patients that underwent EEA with intraoperative CSF leak. Two reconstructive protocols were defined based on different reconstructive techniques; both were vascularized but one monolayer and the other multilayer. A multivariate analysis was performed with outcome variable presentation of postoperative leak.<\/jats:p><jats:p>\n          Results\u2003One hundred one patients were included in the study. Patients reconstructed with protocol 1, with the diagnosis different to the pituitary adenoma and older than 45 years old had higher risk of presenting postoperative leak, and with statistically significant differences when we adjusted for the remaining variables.<\/jats:p><jats:p>\n          Conclusion\u2003The vascularized reconstructions after endoscopic endonasal skull base approaches have demonstrated to be able to obtain a low rate of postoperative CSF leak. The multilayer vascularized technique may provide a more evolved technique, even reducing the postoperative leak rates comparing with the monolayer vascularized one. The reconstructive protocol employed in each case, as well as age and histological diagnosis, is independent risk factor for presenting postoperative leak.<\/jats:p>","DOI":"10.1055\/s-0039-1677705","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T23:59:50Z","timestamp":1551398390000},"page":"128-135","source":"Crossref","is-referenced-by-count":21,"title":["Impact of Multilayer Vascularized Reconstruction after Skull Base Endoscopic Endonasal Approaches"],"prefix":"10.1055","volume":"81","author":[{"given":"Juan Antonio","family":"Simal-Juli\u00e1n","sequence":"additional","affiliation":[{"name":"Neurosurgical Department HUiP La Fe Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Miranda-Lloret","sequence":"additional","affiliation":[{"name":"Neurosurgical Department HUiP La Fe Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"P\u00e9rez de San Rom\u00e1n Mena","sequence":"additional","affiliation":[{"name":"Neurosurgical Department HUiP La Fe Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Sanrom\u00e1n-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Neurosurgical Department HUiP La Fe Valencia, Valencia, Spain"},{"name":"Neurosurgical Department H \u00c1lvaro Cunqueiro Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Garc\u00eda-Pi\u00f1ero","sequence":"additional","affiliation":[{"name":"ENT Department HUiP La Fe, Valencia, Pontevedra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Sanchis-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Anaesthesiology Department H General Universitario de Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Botella-Asunci\u00f3n","sequence":"additional","affiliation":[{"name":"Neurosurgical Department HUiP La Fe Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Kassam","sequence":"additional","affiliation":[{"name":"Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,2,28]]},"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1677705.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T07:14:04Z","timestamp":1587021244000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1677705"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,28]]},"references-count":0,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2020,3,19]]},"published-print":{"date-parts":[[2020,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1677705","relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,28]]}}}