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. 2011 May;21(3):185-8.
doi: 10.1055/s-0031-1275260.

Endoscopy-assisted iliotibial tract harvesting for skull base reconstruction: feasibility on a cadaveric model

Andrea Bolzoni Villaret, Alberto Schreiber, Paolo Battaglia, Maurizio Bignami

Endoscopy-assisted iliotibial tract harvesting for skull base reconstruction: feasibility on a cadaveric model

Andrea Bolzoni Villaret et al. Skull Base. 2011 May.

Abstract

During the last years, multiple methods and a wide set of materials for skull base reconstruction have been described. In our experience, the ideal graft for duraplasty is the iliotibial tract due to its favorable characteristics in terms of thickness, pliability, and strength. In this report, we show the iliotibial tract-harvesting technique under endoscopic guidance with a minimally invasive approach using a cadaveric model. Two longitudinal incisions of 1 cm each were made at 4 cm down a line drawn between the anterior-superior iliac spine and the lateral margin of patella at the extremities of the middle third of the thigh. By using a set of instruments for endoscopic face-lifting, the graft was easily set up and harvested. The endoscopic approach is associated with less visible scars, but longer operative time in comparison with open traditional procedure. The pros and cons in terms of morbidity need to be evaluated by further studies on actual cases.

Keywords: Iliotibial tract; cadaveric model; endoscopic harvesting; skull base reconstruction.

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Figures

Figure 1
Figure 1
Two incisions of 1 cm each were made at the extremities of the middle third of the thigh (A). The surgical field is controlled by two different operative corridors for the scope and instrumentation (B). The graft is taken out through one of the two incisions (C).
Figure 2
Figure 2
A 30-degree endoscope is inserted into the optical retractor (A). Dissection of the subcutaneous tissue from the underlying ITT is performed (B) with exposure of the entire surgical field (C). SC, subcutaneous tissue; ITT, iliotibial tract.
Figure 3
Figure 3
The graft is harvested with the assistance of a malleable dissector (A), scissors (A and B), and pincer (A and C). ITT, iliotibial tract; SC, subcutaneous tissue; VLM, vastus lateralis muscle.
See this image and copyright information in PMC

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