The posterior pedicled inferior turbinate–nasoseptal flap: a potential combined flap for skull base reconstruction

Wu, Pinghua; Li, Zeyu; Liu, Chang; Ouyang, Jun; Zhang, Shizhen

doi:10.1007/s00276-015-1516-6

Cited by 15 publications

(9 citation statements)

References 30 publications

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“…If, for any reason, this does not work, there are several other options through the nasal cavity for skull base reconstruction. 25,33,34 In approximately one-third of our patients, surgery alone was sufficient to manage recurrent tumors that were stable during long-term follow-up after either a GTR or NTR. These patients did not receive RT or any other alternative therapy.…”

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confidence: 91%

Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up

Turel

Tsermoulas

Gonen

et al. 2016

FOC

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OBJECTIVE The treatment of recurrent and residual craniopharyngiomas is challenging. In this study the authors describe their experience with these tumors and make recommendations on their management. METHODS The authors performed an observational study of adult patients (≥ 18 years) with recurrent or residual craniopharyngiomas that were managed at their tertiary center. Retrospective data were collected on demographics and clinical, imaging, and treatment characteristics from patients who had a minimum 2-year follow-up. Descriptive statistics were used and the data were analyzed. RESULTS There were 42 patients (27 male, 15 female) with a mean age of 46.3 ± 14.3 years. The average tumor size was 3.1 ± 1.1 cm. The average time to first recurrence was 3.6 ± 5.5 years (range 0.2–27 years). One in 5 patients (8/42) with residual/recurrent tumors did not require any active treatment. Of the 34 patients who underwent repeat treatment, 12 (35.3%) had surgery only (transcranial, endoscopic, or both), 9 (26.5%) underwent surgery followed by adjuvant radiation therapy (RT), and 13 (38.2%) received RT alone. Eighty-six percent (18/21) had a gross-total (n = 4) or near-total (n = 14) resection of the recurrent/residual tumors and had good local control at last follow-up. One of 5 patients (7/34) who underwent repeat treatment had further treatment for a second recurrence. The total duration of follow-up was 8.6 ± 7.1 years. The average Karnofsky Performance Scale score at last follow-up was 80 (range 40–90). There was 1 death. CONCLUSIONS Based on this experience and in the absence of guidelines, the authors recommend an individualized approach for the treatment of symptomatic or growing tumors. This study has shown that 1 in 5 patients does not require repeat treatment of their recurrent/residual disease and can be managed with a “scan and watch” approach. On the other hand, 1 in 5 patients who had repeat treatment for their recurrence in the form of surgery and/or radiation will require further additional treatment. More studies are needed to best characterize these patients and predict the natural history of this disease and response to treatment.

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mentioning

confidence: 91%

Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up

Turel

Tsermoulas

Gonen

et al. 2016

FOC

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“…These were taken on every CT scan and used in various combinations to calculate the dimensions for each flap and SSBD. For flaps whose radioanatomy has not been previously analyzed (the ALNW and MTF), the key measurements were based on the operative techniques used to raise them …”

Section: Methodsmentioning

confidence: 99%

“…For flaps whose radioanatomy has not been previously analyzed (the ALNW and MTF), the key measurements were based on the operative techniques used to raise them. 4,6,8,9,11,13,19,25 Images were analyzed using the Medical Imaging Interaction Toolkit (version 2015.05; German Cancer Research Center, Heidelberg, Germany) and Slicer (version 4.4.0; Harvard University, Cambridge, MA) to determine the dimensions of SSBDs and endonasal flaps. Statistical analysis of the results was carried out using Microsoft Excel 2013 (version 15.0.4737.1003; Microsoft, Redmond, WA), iNZight (version 2.5; The University of Auckland, Auckland, New Zealand), and GraphPad Prism for Windows (version 6.01; GraphPad, San Diego, CA).…”

Section: Methodsmentioning

confidence: 99%

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The radioanatomy of endonasal flap coverage of skull base defects: A tool for preoperative planning

MacArthur

McGarry

2017

The Laryngoscope

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“…Large skull base defects may be reconstructed with the posterior pedicled inferior turbinate-nasoseptal flap, a large intranasal flap based on the posterior lateral nasal artery. 42 Resected turbinates can be also used for sellar reconstruction at the end of surgery for small defects and may be considered when the nasoseptal flap is unavailable due to prior surgery. 43 Packing following endonasal endoscopic skull base surgery Surgeons are not obliged to use nasal packing or stents provided there is no heavy bleeding or concern for structural compromise.…”

Section: Skull Base Reconstructionmentioning

confidence: 99%

Perioperative nasal and paranasal sinus considerations in transsphenoidal surgery for pituitary disease

Caulley

Uppaluri

Dunn

2020

British Journal of Neurosurgery

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Endoscopic endonasal skull base surgery has emerged as the treatment modality of choice for a range of skull base lesions, particularly pituitary adenomas. However, navigation and manipulation of the nasal corridor and paranasal sinuses requires that surgeons are aware of effective techniques to maximize patient outcomes and avoid sinonasal morbidity postoperatively. This paper is a narrative review aimed to provide an updated and consolidated report on the perioperative management of the nasal corridor and paranasal sinuses in the setting of endoscopic skull base surgery for pituitary disease. Anatomic variants and common surgical techniques are discussed. Post-operative complications are evaluated in detail. Understanding the structural implications of the endonasal approach to the sphenoid is crucial to optimization of the surgical outcomes. We propose guidelines for perioperative management of endoscopic endonasal skull base surgery for pituitary diseases. Standardized treatment algorithms can improve patient satisfaction, and increase the comparability and the quality of reported information across research studies.

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The posterior pedicled inferior turbinate–nasoseptal flap: a potential combined flap for skull base reconstruction

Cited by 15 publications

References 30 publications

Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up

Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up

The radioanatomy of endonasal flap coverage of skull base defects: A tool for preoperative planning

Perioperative nasal and paranasal sinus considerations in transsphenoidal surgery for pituitary disease

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