Juan R Gras-Cabrerizo1, Juan R Gras-Albert2, Irene Monjas-Canovas2, Elena García-Garrigós3, Joan R Montserrat-Gili4, Francisco Sánchez del Campo5, Katarzyna Kolanczak4, Humbert Massegur-Solench4. 1. Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: jgras@santpau.cat. 2. Servicio de Otorrinolaringología, Hospital General Universitario, Universidad Miguel Hernández, Alicante, España. 3. Servicio de Radiología, Hospital General Universitario, Universidad Miguel Hernández, Alicante, España. 4. Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España. 5. Unidad de Anatomía y Embriología Humana, Universidad Miguel Hernández, Alicante, España.
Abstract
INTRODUCTION: Local pedicle flaps based on the sphenopalatine artery make it possible to reconstruct large defects of the skull base (SB). MATERIAL AND METHODS: From January 2008 to January 2013, 64 lesions with involvement of SB were analysed. These lesions were treated using endoscopic endonasal approach and required a pedicle flap based on the sphenopalatine artery. In addition, measurements and flexibility of the flaps were examined in 4 cadaveric nasal cavities. RESULTS: Surgical group. Sixty-four nasoseptal flaps (NSF) were used, in 4 cases associated with a middle turbinate flap (MTF), and in 1 case supplemented with an inferior turbinate flap (ITF). Five cerebrospinal fluid fistulas (8%) were noted. Among patients with initial lesions, 7% presented an anosmia. Cadaveric group. The length of the NSF varied between 5.2 cm and 7.7 cm and the width ranged from 3 cm to 4.5 cm. The ITF provided an anterior-posterior distance between 4.2 cm and 5 cm, with a width between 1.2 cm and 2.8 cm. The mean length of MTFs varied between 3.5 cm and 4.2 cm, with a width between 1.4 cm and 1.9 cm. CONCLUSION: The most versatile local flap for the reconstruction of skull base defects is the NSF, and flaps pedicled to the posterolateral nasal artery offer an excellent alternative.
INTRODUCTION: Local pedicle flaps based on the sphenopalatine artery make it possible to reconstruct large defects of the skull base (SB). MATERIAL AND METHODS: From January 2008 to January 2013, 64 lesions with involvement of SB were analysed. These lesions were treated using endoscopic endonasal approach and required a pedicle flap based on the sphenopalatine artery. In addition, measurements and flexibility of the flaps were examined in 4 cadaveric nasal cavities. RESULTS: Surgical group. Sixty-four nasoseptal flaps (NSF) were used, in 4 cases associated with a middle turbinate flap (MTF), and in 1 case supplemented with an inferior turbinate flap (ITF). Five cerebrospinal fluid fistulas (8%) were noted. Among patients with initial lesions, 7% presented an anosmia. Cadaveric group. The length of the NSF varied between 5.2 cm and 7.7 cm and the width ranged from 3 cm to 4.5 cm. The ITF provided an anterior-posterior distance between 4.2 cm and 5 cm, with a width between 1.2 cm and 2.8 cm. The mean length of MTFs varied between 3.5 cm and 4.2 cm, with a width between 1.4 cm and 1.9 cm. CONCLUSION: The most versatile local flap for the reconstruction of skull base defects is the NSF, and flaps pedicled to the posterolateral nasal artery offer an excellent alternative.
Authors: Juan R Gras-Cabrerizo; Elena García-Garrigós; Joan M Ademá-Alcover; Adolfo Sarandeses-Garcia; Maria Martel-Martin; Joan R Montserrat-Gili; Juan R Gras-Albert; Humbert Massegur-Solench Journal: Surg Radiol Anat Date: 2016-01-06 Impact factor: 1.246
Authors: Juan R Gras-Cabrerizo; Elena García-Garrigós; Joan R Montserrat-Gili; Juan R Gras-Albert; Rosa Mirapeix-Lucas; Humbert Massegur-Solench; Miquel Quer-Agusti Journal: Indian J Otolaryngol Head Neck Surg Date: 2017-09-06