Vascularized middle turbinate mucoperiosteal flap in skull base defects: follow-up analysis of 20 cases

George, Shibu; Suresh, Sandeep

doi:10.18203/issn.2454-5929.ijohns20164786

Cited by 3 publications

(7 citation statements)

References 11 publications

(28 reference statements)

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“…This coincided with George et al (16) who revealed that the most common clinical presentation in middle turbinate flap intervention group was unilateral watery nasal discharge (n=13[65%]). Of these 10 patients had spontaneous CSF rhinorrhea while 3 had history of trauma.3 patients presented as recurrent meningitis, 2 following trauma and 1 after spontaneous CSF rhinorrhea.…”

Section: Discussionsupporting

confidence: 85%

Nasoseptal Flap Versus Middle Turbinate Flap in Skull Base Reconstruction

Yehia¹,

Tantawy²,

Ali³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: The expanded endonasal approaches to the skull base are modular approaches that arise from the sphenoidal sinus. The reconstructive techniques in these approaches are key to avoid postoperative complications. Available flaps for reconstruction include the pedicled nasoseptal flap, the trans-pterygoid temporoparietal fascia flap, and the posterior pedicle inferior turbinate flap (PPITF), among others. Recently, the middle turbinate flap and nasoseptal flap have been described in a cadaveric study. Objective: The aim of the current study was to compare results of using nasoseptal versus middle turbinate flaps in skull base reconstruction. Patients and methods: This interventional cohort study was carried out on 24 patients in

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Section: Discussionsupporting

confidence: 85%

Nasoseptal Flap Versus Middle Turbinate Flap in Skull Base Reconstruction

Yehia¹,

Tantawy²,

Ali³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…To date, use of MTFs for the reconstruction of skull base defects in patients has been reported in seven studies with a combined total of 51 patients. [48][49][50][51][52][53][54] All but one reported case were considered successful and were without long-term CSF leaks, infection, pneumocephalus, or significant crusting. The one incidence of MTF failure was due to a necrotic MTF following a failed NSF.…”

Section: Mtf Outcomesmentioning

confidence: 99%

“…The one incidence of MTF failure was due to a necrotic MTF following a failed NSF 51 . Other reported complications include one patient who had transient CSF leakage during the immediate postoperative period that subsided fully, a patient in which an MTF was insufficient to covered the defect, and another in whom an MTF was irreparably torn during the operation 48,54 …”

Section: Intranasal Vascular Pedicled Flapsmentioning

confidence: 99%

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Vascular pedicled flaps for skull base defect reconstruction

Gutierrez

Bennion

Walsh

et al. 2020

Laryngoscope Investig Oto

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Objective: Techniques for reconstruction of skull base defects have advanced greatly since the introduction of the vascular pedicled nasoseptal flap in 2006. The objective of this review is to assess the current state of the field by examining both intranasal and extranasal techniques of vascular pedicled skull base defect repair, their indications and success rates, and novel techniques that are currently under investigation. Methods: A review of the literature describing the use of vascular pedicled flaps in skull base defect reconstruction was conducted using PubMed and Google Scholar. Results: The nasoseptal flap remains the most widely used vascular pedicled flap for endoscopic repair of skull base defects. Its ease of harvest, wide arch of rotation, and high success rates make it a popular choice among surgeons. Several variations including a "rescue" nasopseptal flap have been developed. Other less commonly used pedicled intranasal flaps include the middle turbinate flap and the posterior pedicled inferior turbinate flap. Additionally, several novel vascular pedicled flaps have been developed and tested in small cohorts of patients. Extranasal flaps such as the pericranial flap and the temporoparietal fascia flap are used less frequently than intranasal flaps. However, they remain valuable options for reconstruction in certain situations. Conclusion: Advancements continue to be made in the field of skull base defect reconstruction using vascular pedicled flaps. Though the nasoseptal flap remains the most widely utilized option, additional intranasal techniques continue to be developed and tested to optimize surgical outcomes and patient care.

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“…All the patients in their study were operated on for either pituitary macroadenoma, or arachnoid cyst, or Rathke's cleft cyst. George et al(16) reported 100% success rate with MT flap reconstruction in their study of 20 patients. All their patients had small to medium sized defects.…”

mentioning

confidence: 96%

Outcomes of Middle Turbinate Flap in the Reconstruction of Non-tumorous Ventral Skull Base Defects - an Institutional Review

Manimaran

Lakshmanan

Prateep

et al. 2021

Turk Arch Otorhinolaryngol

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Objective: Middle turbinate (MT) flap, based on the branches of sphenopalatine artery is one of the commonest mucosal flaps used in endoscopic skull base surgery. The objective of this study is to analyze the outcomes of the MT flap in the reconstruction of non-tumorous ventral skull base defects. Methods: A retrospective review of patients was done from 2010-19. Patients who underwent reconstruction for non-tumorous ventral skull base defects using middle turbinate (MT) flap were included in the study. The parameters assessed include patient demography, primary etiology, site of the defect, size of the defect, graft materials used, outcomes and postoperative complications. Results: A total of 13 patients who met the study criteria were included. Three (23.07%) of the patients had meningo-encephalocele, while the remaining 10 (76.93%) had CSF fistula. Isolated foveal defect (53.8%) was the most common site involved, followed by isolated cribriform, combined cribriform-foveal and combined foveal-planar defects. Graft materials used were fascia lata, fat and septal cartilage. MT flap was successfully harvested in 11 (84.6%) patients, with successful outcome in 10/11 patients. Hypoplastic MT was present in two patients, who subsequently required Hadad flap for defect closure. No major complications were reported in the postoperative period. Conclusion:The MT flap is effective in the reconstruction of selective skull base defects. Appropriate surgical technique and expertise are required for successful harvest. Further studies are required to analyze its outcomes in various skull base defects.

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Vascularized middle turbinate mucoperiosteal flap in skull base defects: follow-up analysis of 20 cases

Cited by 3 publications

References 11 publications

Nasoseptal Flap Versus Middle Turbinate Flap in Skull Base Reconstruction

Nasoseptal Flap Versus Middle Turbinate Flap in Skull Base Reconstruction

Vascular pedicled flaps for skull base defect reconstruction

Outcomes of Middle Turbinate Flap in the Reconstruction of Non-tumorous Ventral Skull Base Defects - an Institutional Review

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