Pedicled nasoseptal flap for anterior skull base reconstruction after endoscopic resection of sinonasal malignancies involving the skull base / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To evaluate theefficacy of the pedicled nasoseptal flap for anterior skull base reconstruction after endoscopic resection of sinonasal malignancies involving the skull base.METHODS From September 2008 to May 2016, 31 patients with sinonasal malignancies involving the skull base were treated via transnasal endoscopic surgery and then two type mucoperiosteal flap of contralateral nasal septum were used to repair the anterior skull base defect according to the actual situation, one is a flap supplied by the posterior nasal septal artery and the other is supplied by the anterior and posterior ethmoidal arteries.RESULTS Successful anterior skull base reconstruction was obtained in all 31 cases. Complications included 3 cases of intracranial infection without hemorrhage or hematoma. In addition, cerebrospinal fluid leakage occurred in one case because of tumor recurrence, and leakage was healed by vertebral draining for one week. Another one had occurred as a result of removing the support form nasal cavity.The follow-up lasted from 3 to 66 months, there were no necrosis of the flap or meningoencephalocele occurred and mucoperiosteal flap healed up well.CONCLUSION The vascularized nasoseptal flap is a reliable and preferred repairing material for anterior skull base reconstruction.