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Bilateral Nasoseptal Flaps for Endoscopic Endonasal Transsphenoidal Approach

Authors
 Ji-Hyeon Shin  ;  Seok-Gu Kang  ;  Sung Won Kim  ;  Yong Kil Hong  ;  Sin-Soo Jeun  ;  Eun Hae Kim  ;  Soo Whan Kim  ;  Jin Hee Cho  ;  Yong Jin Park 
Citation
 Journal of Craniofacial Surgery, Vol.24(5) : 1569-1572, 2013 
Journal Title
 Journal of Craniofacial Surgery 
ISSN
 1049-2275 
Issue Date
2013
MeSH
Adult ; Aged ; Cerebrospinal Fluid Rhinorrhea/surgery* ; Endoscopy/methods* ; Female ; Humans ; Intraoperative Complications/surgery* ; Male ; Middle Aged ; Nasal Septum/surgery* ; Pituitary Neoplasms/surgery* ; Retrospective Studies ; Rhinoplasty/methods* ; Skull Base/surgery ; Sphenoid Sinus/surgery* ; Surgical Flaps/surgery*
Keywords
Nasoseptal flap ; bilateral ; endoscopic ; transsphenoidal approach ; reconstruction
Abstract
A nasoseptal flap is used to reconstruct defects in the skull base when cerebrospinal fluid (CSF) leaks after the endoscopic endonasal transsphenoidal approach (EETSA). We evaluated the usefulness of elevating bilateral nasoseptal flaps with the EETSA. Sixty-seven patients (71 procedures, including 4 revisions) underwent the EETSA with bilateral nasoseptal flap elevation. We retrospectively reviewed patients' medical records, including demographic data, surgical procedures, outcomes, and complications. The entire sellar floor was exposed after elevating bilateral nasoseptal flaps. We reconstructed the defect using a right nasoseptal flap in 14 cases with intraoperative CSF leakage. The denuded sphenoidal sinus was covered with a left nasoseptal flap in 13 cases with excessive loss of sphenoidal sinus mucosa. Unused flaps (57 right flaps and 58 left flaps) were repositioned in the original sites. No postoperative CSF leak occurred. All sphenoidal sinuses covered with the left nasoseptal flap healed well without excessive crust. Two patients experienced immediate postoperative bleeding. Septal perforation occurred in 1 patient who underwent a revision operation. Bilateral nasoseptal flap elevation provided good exposure of the sellar floor with the EETSA. The nasoseptal flap could be used to reconstruct the defect after the EETSA and to cover the denuded sphenoidal sinus. The unused flaps could be repositioned in their original sites to minimize the septal defect and could be reused in revision surgery. We suggest that elevating bilateral nasoseptal flaps is a useful surgical technique in a variety of settings with the EETSA.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00001665-201309000-00014&LSLINK=80&D=ovft
DOI
10.1097/SCS.0b013e31829a8105
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87590
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