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Posterior nasoseptal flap in the reconstruction of skull base defects following endonasal surgery

Published online by Cambridge University Press:  09 May 2019

C Singh  and
N Shah
C Singh*
Affiliation:
Department of Otorhinolaryngology, Bombay Hospital and Institute of Medical Science, Mumbai, India
N Shah
Affiliation:
Department of Otorhinolaryngology, Bombay Hospital and Institute of Medical Science, Mumbai, India
*
Author for correspondence: Dr Chandraveer Singh, Department of Otorhinolaryngology, Bombay Hospital and Institute of Medical Science, Marine Line, Mumbai, India, PIN code: 400020 E-mail: [email protected] Fax: +91 022 2208 0871
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Abstract

Objective

To study the clinical outcomes of a posterior nasoseptal flap used in the endonasal reconstruction of anterior skull base defects.

Methods

The early harvested flap was used to reconstruct anterior skull base defects in patients with high-flow on-table cerebrospinal fluid leak. Post-operatively, the patients were analysed for cerebrospinal fluid leak and bleeding.

Results

Of the 100 patients, 87 had macro defects while 13 had micro defects. Non-secretary lesions were present in 60 patients, while secretary lesions were present in 40 patients. Cerebrospinal fluid leak was present in all the patients undergoing surgery, and the majority of them had a lumbar drain fitted. Post-operatively, two patients experienced bleeding and only two patients had a cerebrospinal fluid leak.

Conclusion

The use of a posterior nasoseptal flap for reconstruction of the anterior skull base amongst patients with a high-flow intra-operative cerebrospinal fluid leak can help prevent post-operative cerebrospinal fluid leak. Its applicability to wide patient profiles, with respect to age, size of defect and diagnosis, make it a versatile choice for reconstruction after endonasal anterior skull base surgical procedures.

Keywords

Posterior Nasal Septal FlapSkull BaseCerebrospinal Fluid LeakSurgical Flaps
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 5 , May 2019 , pp. 380 - 385
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr C Singh takes responsibility for the integrity of the content of the paper

References

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