Nasoseptal Flap

Pinheiro‐Neto, Carlos D.; Snyderman, Carl H.

doi:10.1159/000342271

Cited by 36 publications

(62 citation statements)

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“…An onlay graft that is too small is a common cause for failure and postoperative CSF leak. Failure can likewise result from misplacement of the mucosal surface toward the dural defect, an error that can compromise graft adhesion to surrounding bone [16]. With this in mind, care should also be taken in introducing mucosal tissue into the intracranial space, as this can potentially result in intracranial complications and mucocele formation.…”

Section: Key Pointsmentioning

confidence: 99%

“…The NSF is based off of the posterior septal artery, which is a terminal branch of the sphenopalatine artery (SPA). The posterior septal artery often has more than one branch, adding to its robustness, and reducing the possibility of flap compromise because of concomitant sphenoidotomies [16,21].…”

Section: Nasoseptal Flapmentioning

confidence: 99%

“…Techniques for flap elevation, preservation, and reconstruction have been well described [1,8,11, 12,13 && , 16,22]. Briefly, inferior, superior, and anterior incisions in the septal mucosa are made using needle-tip cautery.…”

Section: Nasoseptal Flapmentioning

confidence: 99%

“…Other shortcomings of the NSF include the resulting large anterior mucosal defect, which can result in crusting and possible nasal valve stenosis [9 & ]. This can be partially mediated by placement of a free graft (middle turbinate mucosa often used) over exposed bone or cartilage to help promote healing at the donor site [16].…”

Section: Nasoseptal Flapmentioning

confidence: 99%

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Pedicled flaps in endoscopic skull base reconstruction

Clavenna

Turner

Chandra

2015

Current Opinion in Otolaryngology & Head and Neck Surgery

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Adoption of vascularized pedicled flaps over the last decade, particularly the recently popularized NSF, has greatly reduced complications associated with endoscopic skull base surgery. The need for vascularized flap reconstruction is governed primarily by defect size and location, and by the presence of a high-flow CSF leak. Additional vascularized flaps can be used in conjunction with the NSF, or as an alternative when the NSF is unfavorable or unavailable.

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Section: Key Pointsmentioning

confidence: 99%

Section: Nasoseptal Flapmentioning

confidence: 99%

Section: Nasoseptal Flapmentioning

confidence: 99%

Section: Nasoseptal Flapmentioning

confidence: 99%

See 2 more Smart Citations

Pedicled flaps in endoscopic skull base reconstruction

Clavenna

Turner

Chandra

2015

Current Opinion in Otolaryngology & Head and Neck Surgery

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“…The protective effects of the perineurium extend from the dermis to the Gasserian ganglion. 26,27 However, once the metastasis extends past this point it may involve the dura or extend further back toward the brainstem. Although en bloc resection of the disease up to the Gasserian ganglion is possible, bleeding from the sinuses can be problematic.…”

mentioning

confidence: 99%

Comparative surgical anatomy of endoscopic and open approaches to the skull base

Rompaey¹,

Robert²

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Introduction:The primary goal of the research was to assess the feasibility of minimally invasive surgical approaches to the cranial base. This was accomplished by conducting endoscopic anatomical studies demonstrating innovative surgical corridors. The aim was to detail the anatomy of these hidden areas, difficult to access by traditional surgical approaches, in order to facilitate minimally invasive intervention. Endoscopic surgery minimizes the potentially severe morbidity and mortality of cranial base surgery. Most of the research that has been conducted in this area has focussed on the midline of the skull base. This research has looked at the viability of accessing the lateral regions. Methods:The anatomical studies were conducted at the Georgia Skull Base Research Laboratory located on the Georgia Regents University campus in Augusta, Georgia USA. This laboratory is equipped with endoscopy, latex injected cadavers and the necessary surgical dissection instruments. Each anatomical study incorporated appropriate endoscopic surgical technique to elaborate the specific anatomy. Photographic records were obtained, with subsequent discussion of pertinent findings. Objectively, measurements were made utilizing computed tomography. This quantified the amount of exposure in each of the surgical approaches. As each research project was completed it was submitted for publication in internationally peer-reviewed journals. Results:The endoscopic and open approaches provided access to the lateral regions of the skull base. The endoscopic approach, while more technically difficult, did provide a minimally invasive corridor. The objective measurements obtained from the computed tomographic scans verified this with less tissue removal when compared to the open approaches. The photographic evidence also demonstrated similar access using either approach. Conclusion:The endoscopic endonasal approach to lateral regions of the skull base is anatomically Contributions by others to the thesisOther than as mentioned in each section, and the feedback received from journal peer reviewers, there were no other contributions Statement of parts of the thesis submitted to qualify for the award of another degreeNone ix

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

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151

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Nasoseptal Flap

Cited by 36 publications

References 0 publications

Pedicled flaps in endoscopic skull base reconstruction

Pedicled flaps in endoscopic skull base reconstruction

Comparative surgical anatomy of endoscopic and open approaches to the skull base

ICAR: endoscopic skull‐base surgery

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