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KMID : 0361020100530110696
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Korean Journal of Otolaryngology - Head and Neck Surgery
2010 Volume.53 No. 11 p.696 ~ p.701
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Endoscopic Skull Reconstruction: Nasoseptal Flap Based Reconstructive Options
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Lim Sang-Chul
Lee Dong-Hoon
Yoon Tae-Mi
Lee Joon-Kyoo
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Abstract
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Background and Objectives: The skull base reconstruction following endonasal skull base surgery for the lesions involving the anterior or central skull base is very important to prevent complications such as cerebrospinal fluid (CSF) leak or meningitis. We report our experiences on the reconstruction of skull base d efects using the nasoseptal flap.
Subjects and Method: A retrospective review was conducted on eight cases which involved endoscopic reconstruction of the anterior or central skull base with the nasoseptal flap. Types of the skull base lesions, sites of the defects, surgical methods, and the surgical results were investigated.
Results: The causes of the skull base defect were as follows: resection of the anterior and the central skull base tumors (5), CSF leak after transsphenoidal pituitary adenoma removal (2), and inflammation (1). Sites of the skull base defects included the anterior (n=2) and the central skull base (n=6). Reconstructive options included the abdominal fat and nasoseptal flap (n=5), the pericranial flap and nasoseptal flap (n=1), and the nasoseptal flap alone (n=2). Five cases with CSF leak and three cases with meningitis recovered without sequelae. All the patients who received nasoseptal flaps survived. Postoperative complications were minimal, but olfactory disturbance occurred in two patients who had undergone endoscopically assisted craniofacial resection. Persistent crusting was noted in all patients.
Conclusion: Our results show that the nasoseptal flap-based endoscopic reconstruction is useful for the treatment of the skull base defect lesions.
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KEYWORD
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Skull base, Reconstructive surgical procedures, Surgical flaps, Nasal septum, Cerebrospinal fluid
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