How I do it: shoelace watertight dural closure in extended transsphenoidal surgery.

Abstract

Skull base reconstruction after extended transsphenoidal surgery is essential to prevent postoperative cerebrospinal fluid leakage. A novel and simple technique for skull base reconstruction termed "shoelace dural closure" was devised. The dura mater was closed with a fat graft using a continuous running suture with both ends of a double-armed suture. The shoelace dural closure is an effective method for achieving watertight closure of the anterior skull base without the use of lumbar drains, fascia lata grafts, or nasoseptal flaps.