J Neurol Surg B 2014; 75 - A185
DOI: 10.1055/s-0034-1370591

Quality of Skull Base Dura, Healing – Pitfall and Pearls during Reconstruction of Skull Base Dura and the Biomechanic Quality of Dura Mater Correlating Histology 3D-Findings and Rewiev of Melvin Study

Jan Hemza 1
  • 1Brno, CZ

The work goals are determination of the dural quality of the skull base area under localisation and there are into anterior skull base fossa. The method of histology of dural sheats into 3 mutually perpendicular coordinate axis, finding out their biomechanic characteristics and correlation with Melvin and cooworkers study from 1970y. From this study procceds the study of healling dura mater, including of skull base bone.We used special testing system MTS 858.2 Mini Bionix and the histology methods. We study different part of dura mater (convexity, anterior, middle, posterior skull base fossa, clivus, middle part of skull base, lamina cribrosa part, pyramida part). Our study the used the technic of biomechanic study of dura mater in 2 mutually perpendicular plane. The biomechanic study is correlated with histological study, when dura mater is studed in 3 perpendicular histology plane – 3D study.

Results: In literature there is only one study of biomechanic quality of dura mater – Melvin 1970. In our study on the convexity and anterior fossa the dura mater have different biomechanical characteristics in coronal and sagital way. (the convexity dura mater in the direct of coronal way, the anterior skull base fossa in the direct of sagital way dura mater is more tenacious, more resistant). The cribriform plate and midle part of skull base – clival and apical pyramidal dura mater is very thin and have low biomechanical characteristics. The best biomechanical characteristic have convexital dura mater, posterior fossa, falx and tentorium. In the study we have in sagital and coronal plane on convexity and anterior skull base 2 different biomechanical quality. This biomechanical study is in correlation of histolotogical study of space collagen distribuction. The biomechanical stress is very important for the healing of tissue, prefered collagen tissue.

Diagram: The effects of mechanical stress on different part of healling

Conclusion: The dura on convexity is the strongest and the most stiff, firm cover of brain, to the skull base way comes to this thin, is finner-grained, less strong and less stiff.

The biomechanical study during tensile test indicate to inner structure of material. The dura mater on skull base form the barrier intracranial and extracranial parts, which is thresholdly strong and form protection for crossway structures (vessels and nerves) through skull base with special arrangement surround their, to preserve separation intracranial space from surround. The dura has functional points (hemodynamic, thermodynamic, liquorodynamic, imnunological, electromagnetic continnuum), but mechanical point of brain protection too.

Author study this problem under this factors (anatomical–embryonal, biomechanical, biophysical, chemical and biological) long time and ruminate over individual influences on healing of skull base on foundation personál experiences with 300 reconstructions of skull base after trauma nad more than 500 reconstructions at the others skull base surgeries. The goal of study is refered to pittfalls et pearls during surgery recunstructions of skull base a to influences, which have be invoved in quality of healing of skull base.