A Novel Reconstructive Technique After Endoscopic Expanded Endonasal Approaches: Vascular Pedicle Nasoseptal Flap

We developed a neurovascular pedicled flap of the nasal septum mucoperiosteum and mucoperichondrium based on the nasoseptal artery, a branch of the posterior septal artery

Gustavo Hadad; Luis Bassagasteguy; Ricardo L. Carrau; Juan C. Mataza; Amin Kassam; Carl H. Snyderman; Arlan Mintz

2006

Key concepts

Scholarcy highlights

  • In patients with large dural defects of the anterior and ventral skull base after endonasal skull base surgery, there is a significant risk of a postoperative cerebrospinal fluid leak after reconstruction
  • We developed a neurovascular pedicled flap of the nasal septum mucoperiosteum and mucoperichondrium based on the nasoseptal artery, a branch of the posterior septal artery
  • Forty-three patients undergoing endonasal cranial base surgery were repaired with the septal mucosal flap
  • Two patients with postoperative cerebrospinal fluid leaks were successfully treated with focal fat grafts
  • Its use has resulted in a sharp decrease in the incidence of postoperative cerebrospinal fluid leaks after endonasal skull base surgery and is recommended for the reconstruction of large dural defects and when postoperative radiation therapy is anticipated

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