{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:04:51Z","timestamp":1777385091906,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2009,3,1]],"date-time":"2009-03-01T00:00:00Z","timestamp":1235865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Rhinol\ufffdAllergy"],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endoscopic repair of skull base (SB) defects is successful in over 90% of cases. Certain factors may contribute to failure of SB repair techniques or need for secondary repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five-year retrospective review of endoscopic SB defect repairs performed by a single surgeon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty-nine patients undergoing 110 procedures to repair 97 SB defects were evaluated. Etiology of defects included surgical\/iatrogenic (64%), spontaneous (17%), traumatic (12%), congenital (6%), and idiopathic (1%). Defects occurred in the sella (41%), sphenoid sinus (18%), ethmoid roof (17%), olfactory cleft (16%), frontal sinus\/recess (6%), and middle cranial fossa (2%). Sixty-three patients (71%) underwent primary SB defect repair and 26 patients underwent secondary repair (29%). In revision cases, mean number of prior repair attempts was 1.5 (range, 1-4). Factors potentially contributing to need for secondary SB defect repair included inability to localize SB defect (p =0 008), development of new SB defect, prior sinus or SB surgery (p &lt; 0.001), prior craniotomy (p &lt; 0.001), prior radiation therapy (p = 0.002), and intracranial infection (p = 0.023). SB defects were successfully closed in 83 patients overall (93%), with success achieved in 97% of primary patients and 85% of secondary patients. Of failures, 3 patients required craniotomy for defect closure, 2 patients underwent permanent cerebrospinal fluid (CSF) diversion, and 1 patient has persistent CSF rhinorrhea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although endoscopic repair of SB defect remains largely successful, certain factors should alert the surgeon to the potential for failure of repair or need for secondary SB defect repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2500\/ajra.2009.23.3293","type":"journal-article","created":{"date-parts":[[2010,2,10]],"date-time":"2010-02-10T20:34:00Z","timestamp":1265834040000},"page":"185-191","source":"Crossref","is-referenced-by-count":23,"title":["Factors Contributing to Failure in Endoscopic Skull Base Defect Repair"],"prefix":"10.1177","volume":"23","author":[{"given":"Sarah K.","family":"Wise","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, and Charleston, South Carolina"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Emory Clinic, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, and Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey G.","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Abingdon Ear, Nose, and Throat Associates, Abingdon, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil J.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce 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