Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Haifa, Israel.
Laryngoscope. 2013 Dec;123(12):2940-4. doi: 10.1002/lary.24186. Epub 2013 Jun 26.
OBJECTIVES/HYPOTHESIS: To demonstrate the feasibility of an anteriorly pedicled inferior turbinate flap (AITF) as a method for endoscopic reconstruction of anterior skull base defects in the absence of a nasal septal flap.
Cadaveric feasibility study.
University-affiliated tertiary medical center.
A cadaveric model was used to investigate the feasibility of harvesting and skull base reconstruction with an AITF. The size and extent of coverage of the flap were investigated. Subsequently, defects resulting from an endoscopic resection of various anterior skull base pathologies were reconstructed with an AITF in patients.
In the cadaveric model (n = 11), the mean length, width, and area of the AITFs were 4.76 ± 0.52 cm, 1.8 ± 0.34 cm, and 4.31 ± 0.87 cm(2), respectively. The flap provided a mean of 111 ± 12% (range 95%-133%) coverage of the anterior skull base from the posterior table of the frontal sinus to the sella. Following that experience, ten patients were successfully reconstructed with AITFs, and there were no postoperative cerebrospinal fluid (CSF) leaks or occurrence of meningitis.
The results of this study demonstrate the feasibility of AITFs for the reconstruction of anterior skull base defects in the absence of alternative vascularized flaps.
目的/假设：展示一种前方带蒂下鼻甲瓣（AITF）作为一种方法，在没有鼻中隔瓣的情况下，用于内窥镜重建前颅底缺损的可行性。
尸体可行性研究。
大学附属三级医疗中心。
使用尸体模型来研究采集和使用 AITF 进行颅底重建的可行性。研究了瓣的大小和覆盖范围。随后，在患者中使用 AITF 对各种前颅底病变的内窥镜切除后的缺损进行重建。
在尸体模型中（n=11），AITF 的平均长度、宽度和面积分别为 4.76±0.52cm、1.8±0.34cm 和 4.31±0.87cm2。该瓣从前额窦的后板到鞍部提供了前颅底 111±12%（范围 95%-133%）的平均覆盖率。在此经验之后，10 名患者成功地使用 AITF 进行了重建，并且没有术后脑脊液（CSF）漏或脑膜炎的发生。
这项研究的结果表明，在没有其他带血管瓣的情况下，AITF 用于重建前颅底缺损是可行的。
