Pinheiro-Neto Carlos D, Snyderman Carl H
Department of Otolaryngology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
Adv Otorhinolaryngol. 2013;74:42-55. doi: 10.1159/000342271. Epub 2012 Dec 18.
The nasoseptal flap had an important role in the development of endoscopic endonasal surgery of the cranial base. The flap is pedicled upon the posterior septal artery, which is a terminal branch of the sphenopalatine artery. The reliable vascular supply promotes rapid healing and the flap is an effective barrier for the prevention of CSF leaks. For large skull base defects, it has dramatically decreased the risk of a postoperative CSF leak to less than 5%. The nasoseptal flap is a versatile flap with a wide arc of rotation that allows the flap to reach defects from the frontal sinus to the lower clivus. This chapter provides a comprehensive review of the nasoseptal flap. The harvesting and reconstruction techniques, modifications of the flap and complications are described.
鼻中隔瓣在颅底鼻内镜手术的发展中发挥了重要作用。该瓣以鼻中隔后动脉为蒂，鼻中隔后动脉是蝶腭动脉的终末分支。可靠的血供促进了快速愈合，且该瓣是预防脑脊液漏的有效屏障。对于大型颅底缺损，它已将术后脑脊液漏的风险显著降低至5%以下。鼻中隔瓣是一种多功能瓣，其旋转弧度宽，可使该瓣到达从额窦到下斜坡的缺损处。本章对鼻中隔瓣进行了全面综述。描述了其切取和重建技术、瓣的改良及并发症。
