Bilateral modified nasoseptal “rescue” flaps in the endoscopic endonasal transsphenoidal approach

Abstract

Bilateral modified nasoseptal rescue flaps elevation provided good exposure of the sellar floor, preserved the septal branch of sphenopalatine artery, and facilitated removal of sellar tumors. We could also preserve more septal mucosa by designing a novel incision and repositioning unused flaps to their original sites. Postoperative complications of the nasal cavity were thus minimized. We believe that this flap is very useful in a variety of settings during the EETSA.

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

“…They did find a transient deficit in postoperative olfaction at 1 month, but this was only in the NSF group, and it went on to return to baseline by 3 months . In contrast, Kim et al utilized bilateral rescue flaps for skull base reconstruction as opposed to NSF, and did find a significant worsening in subjective olfaction measured using a study‐specific VAS …”

Olfactory changes after endoscopic endonasal transsphenoidal approach for skull base tumors

“…The superior incision for the conventional nasoseptal flap used in group A was designed from the inferior border of the sphenoidal sinus ostium following the sagittal plane of the septum, 1 cm below the most superior aspect of the septum, to avoid possible damage to the olfactory mucoepithelium . The curvilinear incision for the modified nasoseptal rescue flap used in group B was made from the inferior border of the sphenoidal sinus ostium following the sagittal plane of the septum made anteriorly toward the level one‐half to one‐third the height of the middle turbinate over the vomer . This curvilinear incision line is located farther from the olfactory neuroepithelium than the superior incision of the conventional nasoseptal flap.…”

Hypernasality after using the endoscopic endonasal transsphenoidal approach for skull base tumors

“…Between February 2009 and March 2014, a total of 413 patients with anterocentral skull‐base tumors, including pituitary adenoma, underwent operations via EETSA at a tertiary referral hospital. Of these patients, 170 underwent operations via bilateral four‐hand EETSA with bilateral modified nasoseptal rescue flaps (BMNRF) and were followed up by voice evaluation for at least 6 months postoperatively …”