| Related Articles |
Septal flip flap for anterior skull base reconstruction after endoscopic transnasal craniectomy: Long term outcomes.
World Neurosurg. 2019 Apr 28;:
Authors: Bozkurt G, Leone F, Arosio AD, Mobaraki PD, Elhassan HA, Seyhun N, Turri-Zanoni M, Castelnuovo P, Battaglia P
Abstract
BACKGROUND: Endoscopic endonasal anterior skull base (ASB) malignant sinonasal tumour resection and reconstruction remains a challenge. We describe our septal flip flap (SFF) reconstruction, a new surgical technique for repairing ASB defects and report our outcomes.
METHODS: We retrospectively reviewed the clinical data of 24 patients who underwent skull base reconstruction using a SFF following endoscopic resection with transnasal craniectomy. We raise the septal flip flap from the contralateral nasal septum based on the septal branches of the anterior and posterior ethmoidal arteries; the SFF is then rotated laterally for anterior skull base reconstruction after transnasal resection with craniectomy.
RESULTS: The SFF was used for multiple tumour types including, most commonly, intestinal-type adenocarcinoma, followed by olfactory neuroblastoma, squamous cell carcinoma, sinonasal undifferentiated carcinoma and other types. All of the cases had either preoperative or postoperative radiation therapy. All flaps remained viable postoperatively. Post-operatively, nasal crusting was significantly reduced with faster healing of the surgical cavity.
CONCLUSION: The SFF adds to the clinical armamentarium the opportunity to provide vascularized mucosal coverage extending from the frontal recess back to the planum sphenoidalis. The use of SFF requires careful consideration when dealing with paranasal sinus cancers so as not to infringe oncologic principles.
BACKGROUND: Endoscopic endonasal anterior skull base (ASB) malignant sinonasal tumour resection and reconstruction remains a challenge. We describe our septal flip flap (SFF) reconstruction, a new surgical technique for repairing ASB defects and report our outcomes.
METHODS: We retrospectively reviewed the clinical data of 24 patients who underwent skull base reconstruction using a SFF following endoscopic resection with transnasal craniectomy. We raise the septal flip flap from the contralateral nasal septum based on the septal branches of the anterior and posterior ethmoidal arteries; the SFF is then rotated laterally for anterior skull base reconstruction after transnasal resection with craniectomy.
RESULTS: The SFF was used for multiple tumour types including, most commonly, intestinal-type adenocarcinoma, followed by olfactory neuroblastoma, squamous cell carcinoma, sinonasal undifferentiated carcinoma and other types. All of the cases had either preoperative or postoperative radiation therapy. All flaps remained viable postoperatively. Post-operatively, nasal crusting was significantly reduced with faster healing of the surgical cavity.
CONCLUSION: The SFF adds to the clinical armamentarium the opportunity to provide vascularized mucosal coverage extending from the frontal recess back to the planum sphenoidalis. The use of SFF requires careful consideration when dealing with paranasal sinus cancers so as not to infringe oncologic principles.
PMID: 31042605 [PubMed - as supplied by publisher]
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου