Asymmetric sliding knots for microsutures for skull base defect repair after transnasal endoscopic surgery

Authors:

Максим Александрович Кутин,

Елизавета Владимировна Шелеско,

Дмитрий Владиславович Фомичев,

Олег Ильдарович Шарипов,

Дмитрий Николаевич Андреев,

Илья Валерьевич Чернов,

Надежда Алексеевна Азарова,

Юлия Владимировна Струнина,

Артем Дмитриевич Донской,

Ольга Андреевна Растворова,

Диана Ширваниевна Адуева,

Даниил Андреевич Коняшин,

Гульнара Гаязовна Максютова,

Павел Львович Калинин

Журнал: Вопросы нейрохирургии имени Н.Н. Бурденко. 2026;90(3):73-79.

DOI: 10.17116/neiro20269003173

Read: 1175 раз

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Abstract

The advantage of asymmetrical sliding knot is that it is tightened by pulling only one «main» end of suture, while the other «wrapped» end is inserted into the wound. This method eliminates the need for additional instruments or devices to insert the knot into a narrow and deep wound.

OBJECTIVE

To evaluate feasibility of asymmetrical sliding knots for microsutures in transnasal endoscopic skull base repair.

MATERIAL AND METHODS

Asymmetric sliding suture was used to attach free autofascial flap to dura mater edges in 25 cases of transnasal endoscopic surgeries with intraoperative cerebrospinal fluid leakage. Craniopharyngiomas were resected in 19 cases, pituitary adenoma in 1 case, meningocele in 1 case, sinonasal carcinomas in 2 cases, chondrosarcoma in 1 case and chordoma in 1 case.

RESULTS

Postoperative cerebrospinal fluid leakage was not observed in any case.

CONCLUSION

We confirmed feasibility of asymmetric sliding knots to form microsutures in transnasal endoscopic skull base repair. The key technical parameters of necessary sutures, specifics of needle insertion through the dura mater and free autofascial flap, limitations and difficulties encountered by the authors are described. Sliding interrupted microsutures can be recommended to form dense layer of autologous tissues in transnasal endoscopic skull base repair.

Keywords

microsutures
skull base defect repair
transnasal endoscopic surgery

Дата поступления: 07.10.2025

Дата принятия в печать: 12.03.2026

Дата публикации: 25.05.2026

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