ArticleJournal of neurological surgery. Part B, Skull base2026
Bioengineered Materials for Skull Base Reconstruction-Current Clinical Applications: Systematic Review and Meta-analysis.
Article in Journal of neurological surgery. Part B, Skull base, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Skull base reconstruction (SBR) is a crucial aspect of open and endoscopic skull base surgery. Currently, multilayer reconstruction with vascularized tissues is the standard technique. Despite advancements, complications such as postoperative cerebrospinal fluid leaks (PO-CSF-L) and infections persist. Bioengineered materials (BEM) have emerged for SBR, showing promising results. Methods: A systematic review was conducted using Embase, PubMed, Scopus, and Cochrane databases. We performed a proportional meta-analysis of studies utilizing BEM for SBR and a comparative analysis with control groups that underwent SBR without biomaterials. The odds ratio assessed treatment effects for binary outcomes. Results: From 1,075 potential articles, 14 met the inclusion criteria. Five BEM were identified: hydroxyapatite (HXA), leukocyte-platelet-rich fibrin (L-PFR), collagen matrix (CM), polyglycolic acid (PGA), and porous polyethylene (PP). The analysis included 1,960 patients, with 1,570 in experimental groups using BEM. Pooled data indicated a PO-CSF-L proportion of 0.02% (95% CI: 0.01-0.03%), postoperative CSF diversion (PO-CSF-d) at 0.01% (95% CI: 0.00-0.04), and PO infection at 0.02% (95% CI: 0.00-0.05%). Common effect models showed that CM had a lower total PO infection rate (0.01; 95% CI: 0.00-0.01, Conclusion: Our results indicate that bioengineered materials are viable for skull base reconstruction, associated with low rates of postoperative CSF leaks, diversions, and infections.
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