Ten Dam Ellen, Korsten-Meijer Astrid G W, Schepers Rutger H, van der Meer Wicher J, Gerrits Peter O, van der Laan Bernard F A M, Feijen Robert A
Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands,
Eur Arch Otorhinolaryngol. 2015 Sep;272(9):2371-9. doi: 10.1007/s00405-014-3353-3. Epub 2014 Oct 31.
We hypothesize that three-dimensional imaging using cone beam computed tomography (CBCT) is suitable for calculating nasoseptal flap (NSF) dimensions. To evaluate our hypothesis, we compared CBCT NSF dimensions with anatomical dissections. The NSF reach and vascularity were studied. In an anatomical study (n = 10), CBCT NSF length and surface were calculated and compared with anatomical dissections. The NSF position was evaluated by placing the NSF from the anterior sphenoid sinus wall and from the sella along the skull base towards the frontal sinus. To visualize the NSF vascularity in CBCT, the external carotic arteries were perfused with colored Iomeron. Correlations between CBCT NSFs and anatomical dissections were strongly positive (r > 0.70). The CBCT NSF surface was 19.8 cm(2) [16.6-22.3] and the left and right CBCT NSF lengths were 78.3 mm [73.2-89.5] and 77.7 mm [72.2-88.4] respectively. Covering of the anterior skull base was possible by positioning the NSF anterior to the sphenoid sinus. If the NSF was positioned from the sella along the skull base towards the frontal sinus, the NSF reached partially into the anterior ethmoidal sinuses. CBCT is a valuable technique for calculating NSF dimensions. CBCT to demonstrate septum vascularity in cadavers proved to be less suitable. The NSF reach for covering the anterior skull base depends on positioning. This study encourages preoperative planning of a customized NSF, in an attempt to spare septal mucosa. In the concept of minimal invasive surgery, accompanied by providing customized care, this can benefit the patients' postoperative complaints.
我们假设使用锥形束计算机断层扫描（CBCT）进行三维成像适用于计算鼻中隔瓣（NSF）的尺寸。为了评估我们的假设，我们将CBCT测量的NSF尺寸与解剖测量结果进行了比较。对NSF的延伸范围和血管分布进行了研究。在一项解剖学研究（n = 10）中，计算了CBCT测量的NSF长度和面积，并与解剖测量结果进行比较。通过将NSF从蝶窦前壁和沿着颅底从鞍座放置到额窦来评估NSF的位置。为了在CBCT中观察NSF的血管分布，用彩色碘海醇灌注颈外动脉。CBCT测量的NSF与解剖测量结果之间的相关性非常强（r > 0.70）。CBCT测量的NSF面积为19.8 cm²[16.6 - 22.3]，左右CBCT测量的NSF长度分别为78.3 mm[73.2 - 89.5]和77.7 mm[72.2 - 88.4]。将NSF放置在蝶窦前方可以覆盖前颅底。如果将NSF从鞍座沿着颅底放置到额窦，NSF会部分延伸到筛窦前部。CBCT是一种计算NSF尺寸的有价值的技术。事实证明，CBCT用于显示尸体鼻中隔血管分布不太合适。NSF覆盖前颅底的延伸范围取决于其放置位置。这项研究鼓励对定制的NSF进行术前规划，以尽量保留鼻中隔黏膜。在微创手术理念的同时提供定制化护理，可以改善患者术后的不适。
