The Nasoseptal Chondromucosal Flap: A Rigid Reconstructive Technique for Skull Base and Orbital Defects

ORL ◽  
2020 ◽  
Vol 82 (5) ◽  
pp. 268-273
Author(s):  
Daniel B. Spielman ◽  
Matthew Kim ◽  
Jonathan Overdevest ◽  
David A. Gudis
Keyword(s):  
Skull Base ◽  
Reconstructive Technique ◽  
Orbital Defects

Posterior Pedicle Lateral Nasal Wall Flap: A New Reconstructive Technique for Large Defects of the Skull Base

2011 ◽  
Vol 121 (S5) ◽  
pp. S354-S354
Author(s):  
Carlos M Rivera-Serrano ◽  
Luis Bassagaisteguy ◽  
Gustavo Hadad ◽  
Ricardo Carrau ◽  
Dan Kelly ◽  
...  
Keyword(s):  
Skull Base ◽  
Lateral Nasal Wall ◽  
Reconstructive Technique

Nasoseptal Flap Reconstruction of High Flow Intraoperative Cerebral Spinal Fluid Leaks during Endoscopic Skull Base Surgery

2009 ◽  
Vol 23 (5) ◽  
pp. 518-521 ◽  
Author(s):  
Adam M. Zanation ◽  
Ricardo L. Carrau ◽  
Carl H. Snyderman ◽  
Anand V. Germanwala ◽  
Paul A. Gardner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radiation Therapy ◽  
Skull Base ◽  
Cerebral Spinal Fluid ◽  
High Flow ◽  
Spinal Fluid ◽  
Csf Leak ◽  
Flap Reconstruction ◽  
Nasoseptal Flap ◽  
Reconstructive Technique

Background Over the past 10 years, significant anatomic, technical, and instrumentation advances have facilitated the exposure and resection of intradural lesions via a fully endoscopic expanded endonasal approach (EEA). The vascularized nasoseptal flap (based on the posterior nasoseptal artery) has become our primary endoscopic reconstructive technique. The goals of this study are to prospectively evaluate the nasoseptal flap and high-risk cerebral spinal fluid (CSF) leak variables. Methods Prospective evaluation was performed of EEA patients with intraoperative high-flow leaks (either a cistern or ventricle open to nasal cavity during tumor dissection) who underwent nasoseptal flap reconstruction. Results Seventy consecutive nasoseptal flaps for high-flow intraoperative leaks were evaluated prospectively by the primary author. Twelve risk factors were then graded at the time of the operations and correlated to CSF leak outcomes. The overall postoperative CSF leak rate was 5.7% (4/70). All four postoperative leaks were successfully managed with endoscopic repair and CSF diversion. A multivariate analysis of all 12 risk factors is detailed. Pediatric patients, large dural defects, and radiation therapy were noted to be factors in reconstructive failure. One flap death occurred in a patient with prior surgery and proton therapy, this leak was managed with a temporoparietal flap and endonasal repair. Conclusion The nasoseptal flap is an excellent anterior skull base reconstructive technique. Patients with high-flow intraoperative CSF leaks had a 94% successful reconstruction rate. Patients with skull base proton radiation therapy are at higher risk for flap failure and preparation for nonradiated tissue reconstruction should be discussed with the patient.

scholarly journals Reconstruction of Skull Base and Fronto-orbital Defects following Tumor Resection

Skull Base ◽  
2007 ◽  
Vol 17 (1) ◽  
pp. 059-072 ◽  
Author(s):  
Kurt Laedrach ◽  
Anton Lukes ◽  
Joram Raveh
Keyword(s):  
Skull Base ◽  
Tumor Resection ◽  
Orbital Defects

scholarly journals Oscillopsia following orbitotomy for intracranial tumor resection

2021 ◽  
Vol 12 ◽  
pp. 459
Author(s):  
Eric A. Goethe ◽  
Juliet Hartford ◽  
Rod Foroozan ◽  
Akash J. Patel
Keyword(s):  
Skull Base ◽  
Tumor Resection ◽  
Vascular Pathology ◽  
Skull Base Tumor ◽  
Skull Base Meningioma ◽  
Visual Phenomenon ◽  
Developmental Conditions ◽  
Visual Complaints ◽  
Orbital Defects

Background: Oscillopsia is a visual phenomenon in which an individual perceives that their environment is moving when it is in fact stationary. In this report, we describe two patients with pulsatile oscillopsia following orbitocranial approaches for skull base meningioma resection. Case Description: Two patients, both 42-year-old women, underwent orbitocranial approaches for resection of a right sphenoid wing (Patient 1) and left cavernous sinus (Patient 2) meningioma. Patient 1 underwent uncomplicated resection and was discharged home without neurologic or visual complaints; she presented 8 days later with pulsatile oscillopsia. This was managed expectantly, and MRA revealed no evidence of vascular pathology. She has not required intervention as of most recent follow-up. Patient 2 developed trochlear and trigeminal nerve palsies following resection and developed pulsatile oscillopsia 4 months postoperatively. After patching and corrective lens application, the patient’s symptoms had improved by 26 months postoperatively. Conclusion: Oscillopsia is a potential complication following skull base tumor resection about which patients should be aware. Patients may improve with conservative management alone, although the literature describes repair of orbital defects for ocular pulsations in traumatic and with some developmental conditions.

scholarly journals Evolution and Innovation of reconstructive technique in endoscopic endonasal skull base surgery

2021 ◽  
Vol 1 ◽  
pp. 100597
Author(s):  
I. Bove ◽  
D. Solari ◽  
F. Esposito ◽  
P. Cappabianca ◽  
L.M. Cavallo
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Endoscopic Endonasal ◽  
Reconstructive Technique

scholarly journals Free-Flap Reconstruction of Skull Base and Orbital Defects

2019 ◽  
Vol 33 (01) ◽  
pp. 072-077 ◽  
Author(s):  
Weitao Wang ◽  
Aurora Vincent ◽  
Mofiyinfolu Sokoya ◽  
Scott Kohlert ◽  
Sameep Kadakia ◽  
...  
Keyword(s):  
Skull Base ◽  
Free Tissue Transfer ◽  
Anterior Skull Base ◽  
Free Flap Reconstruction ◽  
Viable Option ◽  
Endoscopic Techniques ◽  
Advantages And Disadvantages ◽  
Tissue Transfer ◽  
Skull Base Defects ◽  
Orbital Defects

AbstractOrbital and anterior skull base defects present a significant challenge for reconstruction due to the complexity of the anatomy and the need for separation of intracranial and extracranial contents in this area. While endoscopic techniques have revolutionized the treatment of many anterior skull base defects, microvascular free tissue transfer is a viable option for large volume defects not suitable for traditional open approaches or for cases where endoscopic techniques have failed. The various free tissue transfer techniques for anterior skull base and orbit, as well as the advantages and disadvantages, are reviewed.

Posterior Pedicle Lateral Nasal Wall Flap: A New Reconstructive Technique for Large Defects of the Skull Base

2012 ◽  
Vol 73 (S 01) ◽  
Author(s):  
G. Hadad ◽  
C. Rivera-Serrano ◽  
L. Bassagaisteguy ◽  
R. L. Carrau ◽  
J. Fernandez-Miranda ◽  
...  
Keyword(s):  
Skull Base ◽  
Lateral Nasal Wall ◽  
Reconstructive Technique

Skull Base Chordomas

1986 ◽  
Vol 19 (4) ◽  
pp. 797-804 ◽  
Author(s):  
Yosef P. Krespi ◽  
Toni M. Levine ◽  
Randy Oppenheimer
Keyword(s):  
Skull Base ◽  
Skull Base Chordomas

Spinal Fluid Leakage After Skull Base Surgical Procedures

1984 ◽  
Vol 17 (3) ◽  
pp. 601-612 ◽  
Author(s):  
Donald L. Myers ◽  
Robert Thayer Sataloff
Keyword(s):  
Skull Base ◽  
Surgical Procedures ◽  
Spinal Fluid ◽  
Fluid Leakage

Management of Cranial Nerve Injury Following Surgery of the Skull Base

1984 ◽  
Vol 17 (3) ◽  
pp. 577-589 ◽  
Author(s):  
Robert Thayer Sataloff ◽  
Donald L. Myers ◽  
Frederic B. Krenter
Keyword(s):  
Skull Base ◽  
Nerve Injury ◽  
Cranial Nerve ◽  
Cranial Nerve Injury
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