Endoscopic reconstruction skull base using pedicled nasoseptal flap and its anatomy measurement.
- Author:
Fuwei CHENG
1
;
Shankai YIN
;
Mohamed Sambi DJAMALDINE
;
Weitian ZHANG
Author Information
1. Department of Otolaryngology, Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 200233, China.
- Publication Type:Journal Article
- MeSH:
Adult;
Endoscopy;
methods;
Humans;
Nasal Septum;
anatomy & histology;
diagnostic imaging;
transplantation;
Skull Base;
diagnostic imaging;
surgery;
Surgical Flaps;
Tomography, X-Ray Computed
- From:
Journal of Clinical Otorhinolaryngology Head and Neck Surgery
2013;27(14):741-744
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:The harvesting procedures on cadaver heads and a radioanatomic study of measuring dimensions of skull base by endoscopic endonasal approach were performed. The measurements could do help to design the nasoseptal mucoperiosteum and improve the rate of repair success.
METHOD:The surgical procedures were demonstrated on cadaver heads specimens. Then 20 adult CT scans of sinus and skull base were calculated by workstations. The dimensions of three different skull base (the defect of anterior skull base/cribriform plate approach, sellar region/planum sphenoidale region and clivus region) of maximum areas, length and width, were measured. And with these data the nasoseptal flap were designed for providing enough area to cover the defect. The distance from the projection of sphenopalatine foramen to related area of skull base were plused for obtaining desired the length of nasoseptal flap.
RESULT:The mean length from the projection of sphenopalatine to the anterior skull base, planum/sella area and clivus were 49.56 mm, 57.47 and 67.19 mm, respectively. The means of areas of anterior dural defect, transsellar defect and panclivectomy were 16.13 cm2, 14.03 cm2 and 13.12 cm2, respectively. The average length of the nasoseptal flap ranged between 64.71-65.93 mm, the width ranged between 28.57-30.95 mm with an average area of 22.95 cm2.
CONCLUSION:One side of nasal septal flap can provide enough area to reconstruct the anterior skull base and planum/sella area. In some cases, the flap can not completely cover the area of clivus region because of the limitation of its length.
