Anatomy of the posterior septal artery with surgical implications on the vascularized pedicled nasoseptal flap

Zhang, Xian; Wang, Eric; Wei, Hongquan; Shi, Jin; Snyderman, Carl H.; Gardner, Paul A.; Fernández-Miranda, Juan C.

doi:10.1002/hed.23775

Cited by 42 publications

(19 citation statements)

References 13 publications

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“…Prior to raising the NSF, the ET opening was first identified with CSF leaking from its orifice. Technical details of raising the NSF have been previously well described . Under visualization with a 0° endoscope, the NSF was outlined on the ipsilateral side of the CSF leak using a needle‐tipped monopolar electrocautery.…”

Section: Methodsmentioning

confidence: 99%

“…Technical details of raising the NSF have been previously well described. 15,16 Under visualization with a 08 endoscope, the NSF was outlined on the ipsilateral side of the CSF leak using a needle-tipped monopolar electrocautery. The pedicle of the NSF containing the posterior septal artery was defined by parallel incisions above the choana along the rostrum of the sphenoid and along the posterior nasal septum at the level of the natural os of the sphenoid sinus ( Fig.…”

Section: Surgical Techniquementioning

confidence: 99%

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Nasoseptal flap closure of the eustachian tube for recalcitrant cerebrospinal fluid rhinorrhea

et al. 2017

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Section: Methodsmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Nasoseptal flap closure of the eustachian tube for recalcitrant cerebrospinal fluid rhinorrhea

et al. 2017

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“…Because of that, during widening the ostium, it is safer to dissect and widen the sphenoid ostium horizontally and superiorly. Alternatively, to use the electrocautery if the ostium will be widening more than 5 mm inferiorly [44]. …”

Section: Sphenoid Sinus Ostium and Posterior Septal Arterymentioning

confidence: 99%

Paranasal Sinus Anatomy: What the Surgeon Needs to Know

Alsaied¹

2017

Paranasal Sinuses

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Performing a smooth and clean sinus surgery goes hand in hand with a perfect understanding of the nasal and paranasal anatomy. Within this chapter, the paranasal and related structures surgical anatomy will be extensively reviewed, with emphasis on the anatomical landmarks and the normal anatomical variations, which have a significant impact on the function, pathology, and surgical procedures of the paranasal sinuses.

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“…Repair then proceeds with elevation of the NSF, as described recently. 17,24,38 In general, the nasal septum is highly vascularized by branches of the sphenopalatine artery, the anterior and posterior ethmoid arteries, and the greater palatine and labial arteries. The NSF can be designed based on the nasoseptal artery, which is a terminal branch of the internal maxillary artery, according to the size and shape of the skull base defect (Figs.…”

Section: Nasoseptal Flapmentioning

confidence: 99%

Surgical anatomy and utility of pedicled vascularized tissue flaps for multilayered repair of skull base defects

Safavi–Abbasi

Komune

Archer

et al. 2016

JNS

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OBJECT The objective of this study was to describe the surgical anatomy and technical nuances of various vascularized tissue flaps. METHODS The surgical anatomy of various tissue flaps and their vascular pedicles was studied in 5 colored silicone-injected anatomical specimens. Medical records were reviewed of 11 consecutive patients who underwent repair of extensive skull base defects with a combination of various vascularized flaps. RESULTS The supraorbital, supratrochlear, superficial temporal, greater auricular, and occipital arteries contribute to the vascular supply of the pericranium. The pericranial flap can be designed based on an axial blood supply. Laterally, various flaps are supplied by the deep or superficial temporal arteries. The nasoseptal flap is a vascular pedicled flap based on the nasoseptal artery. Patients with extensive skull base defects can undergo effective repair with dual flaps or triple flaps using these pedicled vascularized flaps. CONCLUSIONS Multiple pedicled flaps are available for reconstitution of the skull base. Knowledge of the surgical anatomy of these flaps is crucial for the skull base surgeon. These vascularized tissue flaps can be used effectively as single or combination flaps. Multilayered closure of cranial base defects with vascularized tissue can be used safely and may lead to excellent repair outcomes.

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Anatomy of the posterior septal artery with surgical implications on the vascularized pedicled nasoseptal flap

Abstract: We identify 2 high-risk areas for the design of the vascularized PNSF, namely, at the inferior aspect of the sphenoid ostium and the junction of the posterior nasal septum and the choana arch.

Cited by 42 publications

References 13 publications

Nasoseptal flap closure of the eustachian tube for recalcitrant cerebrospinal fluid rhinorrhea

Nasoseptal flap closure of the eustachian tube for recalcitrant cerebrospinal fluid rhinorrhea

Paranasal Sinus Anatomy: What the Surgeon Needs to Know

Surgical anatomy and utility of pedicled vascularized tissue flaps for multilayered repair of skull base defects

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