Surgical Outcomes of Laminectomy, Durotomy and a Non-Synthetic Dura Substitute Application in Ten Dogs with a Spinal Subarachnoid Diverticulum.

This retrospective study aimed to report the surgical treatment and outcomes of laminectomies followed by durotomy and the application of a non-synthetic collagen matrix dura substitute (DurepairTM) in ten dogs with a spinal subarachnoid diverticulum (SAD). The medical records of these ten client-owned dogs with SAD diagnosed by magnetic resonance imaging (MRI) were reviewed. All patients had chronic and progressive deficits. At presentation, common neurological signs were proprioceptive ataxia, ambulatory spastic paraparesis or tetraparesis, and faecal incontinence. Dorsal thoracolumbar laminectomy was performed in eight dogs; one dog underwent cervical dorsolateral laminectomy, and one patient had thoracic hemilaminectomy. Laminectomies were followed by durotomy, allowing the dissection of the pia-arachnoid adhesions. A rectangular patch of a non-synthetic dura substitute was applied as an onlay graft over the durotomy site before routine closure. Proprioceptive ataxia, paraparesis, and tetraparesis improved in all patients. Faecal incontinence in one patient resolved postoperatively. Laminectomy, durotomy, and the application of a non-synthetic dura substitute was a safe procedure facilitating postoperative improvement over a long-term follow-up period (from 9 to 40 months).

Tube Erosion with Scleral Melting after Ahmed Valve Implantation Using a Synthetic Dural Substitute

PURPOSE: The objective of this case report was to present tube erosion of Ahmed valve implantation using a synthetic dura substitute (Neuro-Patch®, B. Braun, Boulogne, France). CASE SUMMARY: Tube erosion was caused by dissolution of the conjunctiva and partial-thickness scleral tunnel in 5 patients who received Ahmed valve implantation using a synthetic dura substitute for glaucoma treatment 2 to 4 months after the operation. Furthermore, the patients required re-operation for preventing secondary complications such as endophthalmitis. CONCLUSIONS: This case series using a synthetic dura substitute in Ahmed valve implantation demonstrated the risk of tube erosion with scleral tunnel melting and following secondary complications even with a partial-thickness scleral tunnel method.

Synthetic dural graft septoplasty in epistaxis from hereditary hemorrhagic telangiectasia / Septoplastia con injerto de dura sintética en epistaxis por telangiectasias hemorrágicas hereditarias

Abstract It is an autosomal dominant vascular disorder, which has a variety of clinical manifestations, with epistaxis being one of the most common. Many treatment options exist for epistaxis, but with no consensus on which is the method of choice. We describe the case of a patient with hereditary hemorrhagic telangiectasia (HHT) secondary epistaxis with septoplasty managed with synthetic hard graft, which improved intensity and frequency of bleeding episodes. This technique is a variant of the septodermoplasty described by several authors, but the use of synthetic dura can help in obtaining better results and avoid taking skin grafts from other sites different from the surgical site.

Resumen Esta condición es un trastorno vascular autosómico dominante, que tiene una variedad de manifestaciones clínicas; entre las más comunes, se encuentra epistaxis. Existen múltiples opciones terapéuticas para la epistaxis, pero no hay un consenso sobre cuál es el método de elección. Se describe el caso de un paciente con epistaxis secundaria a telangiectasias hemorrágicas hereditarias (THH) manejado con septoplastia con injerto de dura sintética, la cual obtuvo mejoría en la intensidad y frecuencia de los episodios de sangrados. Esta técnica es un variante de la septodermoplastia descrita por diversos autores, pero el uso de dura sintética puede ayudar a obtener mejores resultados y evita toma de injertos dérmicos de otros sitios diferentes al sitio quirúrgico.

Synthetic dural graft septoplasty in epistaxis from hereditary hemorrhagic telangiectasia.

It is an autosomal dominant vascular disorder, which has a variety of clinical manifestations, with epistaxis being one of the most common. Many treatment options exist for epistaxis, but with no consensus on which is the method of choice. We describe the case of a patient with hereditary hemorrhagic telangiectasia (HHT) secondary epistaxis with septoplasty managed with synthetic hard graft, which improved intensity and frequency of bleeding episodes. This technique is a variant of the septodermoplasty described by several authors, but the use of synthetic dura can help in obtaining better results and avoid taking skin grafts from other sites different from the surgical site.

Esta condición es un trastorno vascular autosómico dominante, que tiene una variedad de manifestaciones clínicas; entre las más comunes, se encuentra epistaxis. Existen múltiples opciones terapéuticas para la epistaxis, pero no hay un consenso sobre cuál es el método de elección. Se describe el caso de un paciente con epistaxis secundaria a telangiectasias hemorrágicas hereditarias (THH) manejado con septoplastia con injerto de dura sintética, la cual obtuvo mejoría en la intensidad y frecuencia de los episodios de sangrados. Esta técnica es un variante de la septodermoplastia descrita por diversos autores, pero el uso de dura sintética puede ayudar a obtener mejores resultados y evita toma de injertos dérmicos de otros sitios diferentes al sitio quirúrgico.