17 41

Cited 0 times in

Anterior skull base reconstruction using nasoseptal flap: cadaveric feasibility study and clinical implication [SevEN-001]

Authors
 Kyoung Su Sung  ;  Jaejoon Lim  ;  Minkyun Na  ;  Sanghun Lee  ;  Ju-Seong Kim  ;  Je Beom Hong  ;  Chang-Ki Hong  ;  Ju Hyung Moon 
Citation
 JOURNAL OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, Vol.49(1) : 67, 2020-09 
Journal Title
 JOURNAL OF OTOLARYNGOLOGY-HEAD & NECK SURGERY 
ISSN
 1916-0208 
Issue Date
2020-09
Keywords
Anterior skull base ; Nasoseptal flap ; Skull base reconstruction ; Sphenoidotomy
Abstract
Background: Pedicled nasoseptal flap (PNSF) has significantly improved the surgical outcomes of endoscopic endonasal approach (EEAs) by reducing cerebrospinal fluid (CSF) leakage. The purpose of this study is to assess the feasibility of using a PNSF for anterior skull base (ASB) reconstruction and to describe a method to compensate for a short flap based on our results. Methods: In this cadaveric study, ASB dissection without sphenoidotomy was performed using 10 formalin-fixed and 5 fresh adult cadaver specimens, and the sufficiency of the PNSF to cover the ASB was assessed. After the sphenoidotomy, the length by which the PNSF fell short in providing coverage at the posterior wall of the frontal sinus (CPFS), and the extent of the anterior coverage from the limbus (CL) of the sphenoid bone was measured. Results: Without sphenoidotomy, the mean length of the remaining PNSF after the coverage of the posterior wall of the frontal sinus was 0.67 cm. After sphenoidotomy, the PNSF fell short by a mean length of 2.10 cm, in providing CPFS. The CL was 1.86 cm. Based on these findings, defects resulting from an endoscopic resection of ASB tumors were reconstructed using PNSF without total sphenoidotomy in 3 patients. There were no postoperative CSF leaks or complications. Conclusions: The use of PNSF for ASB reconstruction may be insufficient to cover the entire ASB defect after removal of large lesions which need total sphenoidotomy. When possible, by leaving some portion of the anterior sphenoid wall for supporting the PNSF, successful ASB reconstruction could be achieved in endoscopic resection of ASB tumors. Additional methods might be needed in some cases of large ASB lesions wherein the anterior sphenoid wall should be removed totally and the ASB defect is too large.
Files in This Item:
T202004576.pdf Download
DOI
10.1186/s40463-020-00460-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Moon, Ju Hyung(문주형)
Hong, Chang Ki(홍창기) ORCID logo https://orcid.org/0000-0002-2761-0373
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180306
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links