The Posterior Septal Nasal Floor Mucosal Flap for Cranial Base Reconstruction

Bowen, Andrew J.; Eltahir, Ahmed; Goates, Andrew J.; Rezende, Natalia; Leonel, Luciano; Graepel, Stephen; Xie, Katherine; Gompel, Jamie J. Van; Peris-Celda, María; Choby, Garret; Pinheiro‐Neto, Carlos D.

doi:10.1002/lary.30079

Cited by 3 publications

(2 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the width and length of a PS-NF are similar to those of an NSF, the total area of a PS-NF is slightly smaller; therefore, use of a PS-NF should be limited to coverage of skull base defects <3 cm in diameter if high-flow CSF leakage is encountered during surgery [ 7 ]. In our patient, high-flow CSF leakage was encountered and the skull base defect was <3 cm in diameter.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, other reconstructive materials should be used if the flap is too small or flap blood flow is deemed insufficient. Flap hemodynamics can be evaluated using intraoperative indocyanine green angiography [ 7 ], which we are considering using in the future. Interestingly, contrast enhancement of the flap was more pronounced in the second flap.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Takedown and Reuse of a Posterior Septal Nasal Floor Mucosal Flap for Skull Base Reconstruction in a Revision Surgery for a Recurrent Pituitary Tumor

Suzuki¹,

Murakami²,

Miyamoto³

et al. 2023

Cureus

View full text Add to dashboard Cite

Various types of mucosal flaps can be used for skull base reconstruction after endoscopic endonasal skull base surgery (EESS). Preventing postoperative cerebrospinal fluid (CSF) leakage is essential. Flap creation during revision surgery can be problematic. We present a patient in whom a posterior septal nasal floor flap (PS-NF) was successfully reused for reconstruction after multiple reoperations for pituitary tumor resection. A 22-year-old female underwent EESS for resection of a pituitary tumor and experienced multiple recurrences after repeated operations. For the third recurrence, a skull base surgery team comprising otolaryngologists and neurosurgeons performed a binostril combined transnasal/transseptal approach and used a PS-NF for reconstruction. For the fourth recurrence, a PS-NF was successfully taken down and reused for reconstruction. No postoperative CSF leakage or intranasal complications occurred. Skull base reconstruction using a PS-NF is feasible and preserves the mucous membrane of the nasal septum and the morphology of the nasal cavity. PS-NF takedown and reuse is an option for revision EESS for recurrent pituitary tumors.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Takedown and Reuse of a Posterior Septal Nasal Floor Mucosal Flap for Skull Base Reconstruction in a Revision Surgery for a Recurrent Pituitary Tumor

Suzuki¹,

Murakami²,

Miyamoto³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

Multi‐center study on sellar reconstruction after endoscopic transsphenoidal pituitary surgery

Ali,

Leland,

Stickney

et al. 2024

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

IntroductionSurgical techniques for sellar reconstruction include no reconstruction, use of synthetic materials, autologous grafts, and/or vascularized flaps. The aim of this study was to conduct a multi‐center study comparing the efficacy and postoperative morbidity associated with different sellar reconstruction techniques.MethodsA retrospective chart review of patients who underwent endoscopic transsphenoidal surgery for pituitary tumors from five participating sites between January 2021 and March 2023 was performed. The variables included demographics, tumor characteristics, reconstruction technique, postoperative cerebrospinal fluid leak (CSF) leak, and 22‐item Sino‐Nasal Outcome Test (SNOT‐22) scores. Comparisons of postoperative complications, SNOT‐22 scores, and duration of surgery by type of onlay reconstruction were evaluated using Fisher's exact test, analysis of variance, and Kruskal‒Wallis test.ResultsFive hundred and one patients were identified. The median tumor size was 2.1 cm, and 64% were non‐functioning. Intraoperative CSF leak was identified in 38% of patients. A total of 89% of patients underwent onlay reconstruction: 49% were reconstructed with mucosal grafts, 35% with nasoseptal flaps, and 5% with other onlay techniques. Nasoseptal flaps were utilized more frequently in the setting of giant pituitary adenomas (>3 cm), medial cavernous sinus wall resection, and high‐flow intraoperative CSF leaks. Cases who utilized mucosal grafts had an overall shorter operating time (median: 183 min vs. 240 min; p < 0.001). Five postoperative CSF leaks were identified, and therefore, statistical analysis could not be performed for this complication.ConclusionThe effectiveness and morbidity of different sellar reconstruction techniques are comparable. Vascularized flaps were utilized more frequently in the setting of larger tumors and high‐flow intraoperative CSF leaks.

show abstract

The “mini-extended” nasoseptal flap for reconstruction of sella to planum skull base defects

Rimmer,

Manes,

Omay

2024

American Journal of Otolaryngology

View full text Add to dashboard Cite

The Posterior Septal Nasal Floor Mucosal Flap for Cranial Base Reconstruction

Cited by 3 publications

References 31 publications

Takedown and Reuse of a Posterior Septal Nasal Floor Mucosal Flap for Skull Base Reconstruction in a Revision Surgery for a Recurrent Pituitary Tumor

Takedown and Reuse of a Posterior Septal Nasal Floor Mucosal Flap for Skull Base Reconstruction in a Revision Surgery for a Recurrent Pituitary Tumor

Multi‐center study on sellar reconstruction after endoscopic transsphenoidal pituitary surgery

The “mini-extended” nasoseptal flap for reconstruction of sella to planum skull base defects

Contact Info

Product

Resources

About