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Mekonnen M, Hovis G, Mahgerefteh N, Chandla A, Malkhasyan Y, Zhang AB, Yang I. A Case Series of DuraMatrix-Onlay ® Plus in Cranial Surgery Is Associated With a Low Complication Profile. Brain Tumor Res Treat 2023; 11:232-238. [PMID: 37953446 PMCID: PMC10641318 DOI: 10.14791/btrt.2023.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND DuraMatrix-Onlay® Plus is a collagen dura membrane derived from purified bovine Achilles tendon. The matrix provides a scaffold for collagen synthesis and is intended to be used as an onlay without the need for dural sutures. The study aims to describe our experience with 33 consecutive patients who underwent a duraplasty procedure using the novel DuraMatrix-Onlay® Plus collagen dura membrane. METHODS This is a retrospective case series of 33 patients who underwent a duraplasty procedure at a single academic hospital in Los Angeles, CA, USA between May 2016 and March 2017. The primary outcome was the incidence rate of cerebrospinal fluid (CSF) leak. Secondary outcomes included rates of patient infection, dural substitute complication, and removal. RESULTS Thirty-three patients underwent a duraplasty procedure using the DuraMatrix-Onlay® Plus material. The average age of the patients was 41.12±7.34 years (range 2-75 years). There were 18 (54.5%) females and 15 (45.5%) males. The majority of procedures were elective operations for the resection of a lesion (n=19, 58%), and the average graft size was 17.69±4.73 cm². At an average follow-up of 3 months, there were no postoperative CSF leaks. The rates of patient infection, dural substitute complication, and removal were 6%, 6%, and 3%, respectively. CONCLUSION DuraMatrix-Onlay® Plus is associated with a low rate of postoperative CSF leakage and an acceptable complication profile. This result supports the use of collagen matrices for dural closure in general neurosurgical procedures.
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Affiliation(s)
- Mahlet Mekonnen
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Gabrielle Hovis
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Natalie Mahgerefteh
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anubhav Chandla
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Yelena Malkhasyan
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ashley B Zhang
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Isaac Yang
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, Ronald Reagan UCLA Medical Center of the David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
- Los Angeles Biomedical Research Institute (LA BioMed), Harbor-UCLA Medical Center, Torrance, CA, USA.
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Mahgerefteh N, Mozaffari K, Teton Z, Malkhasyan Y, Kim K, Yang I. Incidental Meningiomas: Potential Predictors of Growth and Current State of Management. Neurosurg Clin N Am 2023; 34:347-369. [PMID: 37210125 DOI: 10.1016/j.nec.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The rise in availability of neuroimaging has led to an increase in incidentally discovered meningiomas. These tumors are typically asymptomatic and tend to display slow growth. Treatment options include observation with serial monitoring, radiation, and surgery. Although optimal management is unclear, clinicians recommend a conservative approach, which preserves quality of life and limits unnecessary intervention. Several risk factors have been investigated for their potential utility in the development of prognostic models for risk assessment. Herein, the authors review the current literature on incidental meningiomas, focusing their discussion on potential predictive factors for tumor growth and appropriate management practices.
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Affiliation(s)
- Natalie Mahgerefteh
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Khashayar Mozaffari
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Zoe Teton
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Yelena Malkhasyan
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Kihong Kim
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Isaac Yang
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Department of Radiation Oncology, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Department of Head and Neck Surgery, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Jonsson Comprehensive Cancer Center, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Los Angeles Biomedical Research Institute, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Harbor-UCLA Medical Center, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; David Geffen School of Medicine, Los Angeles, 100 West Carson Street, Torrance, CA 90502, USA.
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