The repair of cerebrospinal fluid rhinorrhea: comparison of histopathologic findings with cadaveric human temporal fascia, dura mater, and autologous fascia in a rabbit model.

OBJECTIVES To evaluate the repair of cerebrospinal fluid rhinorrhea through the transnasal approach, we investigated histopathologic findings of grafting with human temporalis fascia and dura mater in a rabbit model. DESIGN AND METHODS Thirty-two rabbits were assigned to three groups according to the graft material to be used: human dura mater, human temporalis fascia, and autologous muscle fascia (control group). The repair of the surgically induced bony opening was performed via the transnasal approach. To evaluate healing process histopathologically, decapitation was performed at the end of 1, 2, 3, and 4 weeks in the control group; 1, 2, 3, 4, 32 and 40 weeks in the dura mater group; 4, 32 and 40 weeks in the temporalis fascia group. RESULTS Macroscopically, adhesions to the cerebral cortex were not observed with any of the grafts. Histopathologically, complete healing occurred in four weeks in the control group. Healing took longer in both cadaveric graft groups, in which formation of giant cells was the most prominent feature at the end of four weeks, suggesting a late rejection. Nevertheless, these cells disappeared and complete resolution was observed at the end of 32 and 40 weeks. Despite prolonged healing, no adverse clinical effects were observed. CONCLUSION This experimental model showed that human temporalis fascia can be used instead of dura mater in the repair of cerebrospinal fluid rhinorrhea.