The autologous fat has come as alternative to various substitute materials being used previously.

Bohoun et al., reported there experience and technique for the repair of notable skull base dural defects, using autologous fat as dural substitute.

Over a period of five years, 71 consecutive patients operated for skull base pathologies, with an important intra-operative dural defect, repaired using autologous fat tissue as replacement material were reviewed. The graft, withdrawn from the abdomen or thigh was flattened and applied to the defect. The clinical findings and outcomes were assessed.

Main pathologies included Schwannomas (45%) and meningiomas (35.21%), with no side predilection. Surgical approaches such as transcondylar fossa, suboccipital, fronto-temporal; approaches were used. Dural defects were mainly located in the posterior (73.2%) and; middle cranial fossae (25.4%). No harvesting-site related complication occurred. In seven cases, transitory subcutaneous fluid collection, spontaneously resorbing after 8 days to 2 months was; observed. No external cerebrospinal fluid leakage, infection or other complication was noted during the following period.

Dural repair can be effectively and durably achieved using autologous fat graft as dural substitute during skull base approaches, even in cases of extended defects. The observed characteristics of the fat graft along with the achieved outcome make it an ideal dural substitute ¹⁾.