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  • Free Temporalis Muscle Fasc...
    Jurlina, Martin; Biloš, Jerko; Jednacak, Hrvoje; Peterkovic, Vjerislav; Pukšec, Mirjana

    Journal of Neurological Surgery Part B: Skull Base, 09/2016, Letnik: 77, Številka: S 02
    Conference Proceeding, Journal Article

    Objective: In the last 5 years we regularly use free temporalis muscle fascia transplant as a reconstructive material for dural defects in both open and endoscopic surgical procedures. The objective of our investigation is to compare biomechanical characteristics of free temporalis muscle fascia and fascia lata transplant to those of dura. Material and Methods: Biomechanical study encompasses 80 fresh human cadaver autopsy specimens; 35 temporalis muscle fascia samples, 21 fascia late samples and 24 dural samples. All samples underwent stretching test within 24 hours after being harvested. Stretching test consisted of two sequences. First we have stretched 39 samples with the extension speed rate of 0.05 mm/s until limited extension of 6%, a threshold value for fascia lata, where it loses its elasticity. In the second part of the test we have stretched 41 samples with calculated average default dural strain at the threshold point where it loses its elasticity, with the 25%, 50%, 75% and 100% of that calculated default strain, consequently. Results and Conclusion: Temporalis muscle fascia has the best elastic properties in comparison to dura and fascia lata. It tolerates strain much better than dura and fascia lata, especially at lower values of default strain (25 and 50% of elastic limit of dura) which are the closest to physiologic forces during normal human activity. Fascia lata is the stiffest material of all three, while dura is somewhere in-between them. This proves that temporalis muscle fascia is the best reconstructive material because it produces the smallest force on the edge of defect due to its elasticity, and it tolerates extension much better than fascia lata. Its biomechanical characteristics are much closer to those of dura in comparison to fascia lata. These advantages are especially pronounced in endoscopic repair of dural defect where only adhesive forces keep reconstructive material in its place.