Characterization and morphological comparison of human dura mater, temporalis fascia, and pericranium for the correct selection of an autograft in duraplasty procedures

The objective of this study was to characterize and compare the morphological characteristics of the dura mater, the pericranium, and the temporal fascia to ascertain the most adequate tissue to use as a dura graft. 20 dura mater, 20 pericranium and 20 temporalis fascia samples were analyzed. Each of the samples was stained with hematoxylin and eosin, orcein, Van Gieson, Masson's trichrome and Verhoeff-Van Gieson (600 slides in total) for a general morphological evaluation, as well as a quantitative, morphometric and densitometric analysis of elastic fibers present in each of the tissues. The micro-densitometric analysis of the tissues indicated that the area occupied by the elastic fibers showed values of 1.766 +/- 1.376, 4.580 +/- 3.041, and 8.253 +/- 4.467 % for the dura mater, the temporalis fascia and the pericranium, respectively (p < 0.05, all pairs). The values observed in the analysis of the density intensity were 3.42E+06 +/- 2.57E+06, 1.41E+07 +/- 1.28E+07, and 1.63E+07 +/- 9.19E+06 for the dura mater, the temporalis fascia and the pericranium, respectively (p < 0.05), dura mater vs. temporalis fascia and dura mater vs. pericranium). This is the first study to compare the dura mater with tissues for dural autograft and to quantify the elastic component present in these tissues. The results indicate that the temporalis fascia is a better dural graft because of its intrinsic tissue properties.