Citations 14

The Superior Nasal Septum Arterial Pattern: An Anatomical Study of the S-Point Area

Journal of Neurological Surgery Part B: Skull Base | March 4, 2022 | Volume: 83 | Issue: S 01 | Pages: S1-S270

10.1055/s-0042-1743716

Radiological Study of the Posterior Septum—Nasal Floor Mucosal Flap

Journal of Neurological Surgery Part B: Skull Base | March 4, 2022 | Volume: 83 | Issue: S 01 | Pages: S1-S270

10.1055/s-0042-1743703

The Lingual Process of the Sphenoid Bone and the Petrolingual Ligament: Description, Landmarks, and Clinical Relevance

Journal of Neurological Surgery Part B: Skull Base | March 4, 2022 | Volume: 83 | Issue: S 01 | Pages: S1-S270

10.1055/s-0042-1743596

The Posterior Septal Nasal Floor Mucosal Flap for Cranial Base Reconstruction

The Laryngoscope | February 28, 2022 | Volume: 132 | Issue: 8 | Pages: 1561-1568

10.1002/lary.30079 | PMID 35226356

ObjectiveWhile pedicled intranasal flaps, such as the nasoseptal flap (NSF), successfully reduce postoperative CSF leaks following endoscopic endonasal approaches (EEA) to the skull base, morbidity remains prevalent. This study describes the first cadaveric description and radiographic analysis of the posterior septal nasal floor mucosal flap (PSNF) designed to reduce pedicled nasal flap morbidity. A case series is also detailed.Study DesignCadaveric dissection, radiographic analysis, and case series.MethodsSeven cadaver specimens underwent harvest of the PSNF. PSNF flap dimensions were measured on the thirty deidentified sinus computed tomography (CT) scans. A retrospective case series was performed on the first set of patients who received the PSNF for reconstruction of a sellar base defect. Information concerning complications, symptoms, and the appearance of the flap was recorded from records of the patient's postoperative inpatient stay, 1‐week postop visit, and 1‐month postop visit.ResultsCadaver dissection of the PSNF flap demonstrated good arc rotation along its pedicle with ability to cover both sellar and planum defects. Cadaveric flap measurements and CT‐derived measurements estimated a mean surface area of 16.7 and 18.3 cm2, respectively. 15 patients underwent reconstruction of a sellar or planum defect using the PSNF technique. Only one CSF leak was encountered postoperatively. Minimal crusting of the flap and donor site was seen 1 month postoperatively.ConclusionThe PSNF flap provides a sizeable pedicled region for reconstruction comparable to other pedicled nasal flaps. Our case series demonstrated good postoperative outcomes without reduced donor site morbidity.Level of Evidence4 Laryngoscope, 132:1561–1568, 2022