Simple rigid skull base reconstruction with resorbable unsintered hydroxyapatite/poly-l-lactide plate in endoscopic endonasal skull base tumor surgery: illustrative case.

BACKGROUND

Skull base reconstruction following an extended endoscopic endonasal approach (EEA) is essential for preventing postoperative CSF leakage. Despite recent advancements in surgical techniques and materials, CSF leakage remains a significant complication. This report presents a rigid reconstruction technique utilizing a resorbable unsintered hydroxyapatite/poly-l-lactide (u-HA/PLLA) plate to reduce postoperative CSF leakage.

OBSERVATIONS: Between May 2024 and June 2025, this method was used in 10 cases of extended EEA involving high-flow intraoperative CSF leaks and bone defects more than 25 mm. Notably, no postoperative CSF leakage was observed following the introduction of the u-HA/PLLA plate.

LESSONS: This material offers a unique combination of flexibility and mechanical strength comparable to cortical bone, along with osteoconductivity and bioresorbability, while producing negligible interference on postoperative imaging. These properties make it a highly promising material for skull base reconstruction. https://thejns.org/doi/10.3171/CASE25544.