Background: Defects of the dura in the rhinobasal area can be closed transnasally. Various procedures with autologous or alloplastic material can be chosen.
Method: From 2001 to 2004, we closed a rhinobasal dura defect with Ethisorb or Ethisorb durapatch in sandwich technique in 8 patients. After smoothing the bone edges, Ethisorb is applied under microscopic or endoscopic view endocranially, extradurally as "underlay" to seal and absorb the liquor pressure pillar. Additionally, another Ethisorb implant as "underlay" is applied extracranially from endonasally as "underlay", and sealed with a further layer of nasal concha mucosa with fibrin glue.
Results: All patients were successfully treated with this technique. There were no evidences for persisting rhinoliquorrhoe after the period of wound healing. For hemostasia, a nasal package was applied for compression at the donor site of the inferior nasal concha. The former dura defect was at all times freely accessible in order to be able to recognize a possible new rhinoliquorrhoea early and to prevent a possible congestive secretion with superinfection.
Discussion: The material of Ethisorb and Ethisorb durapatch is stiff and can be easily modelled, so it is an alternative as an alloplastic material for endonasal closure of defined substantial defects of the dura with rhinoliquorrhoe.