Kim Boo-Young, Shin Ji Hyeon, Kim Sung Won, Hong Yong Kil, Jeun Sin-Soo, Kim Soo Whan, Cho Jin Hee, Park Yong Jin
*Department of Otolaryngology-Head and Neck Surgery, Uijeongbu St. Mary's Hospital †Minimal Access and Robotic Surgery Center, Seoul St. Mary's Hospital ‡Department of Biomedical Science §Department of Neurosurgery, The Catholic University of Korea, College of Medicine, Seoul, Korea.
J Craniofac Surg. 2017 Mar;28(2):468-471. doi: 10.1097/SCS.0000000000003393.
Reconstruction of the skull base using a pedicled nasoseptal flap (NSF) seems to be advantageous after the endoscopic endonasal transsphenoidal approach (EETSA). A few reports have evaluated the cause of flap failure in EETSA using NSFs. The aim of this study was to evaluate the perioperative risk factors for NSF failure.
Patient series.
Retrospective review of medical records at a tertiary referral center.
The study population comprised patients who underwent EETSA with NSF elevation between February 2009 and March 2014. The authors retrospectively reviewed the all patients' medical records, including operative findings.
Four hundred thirteen patients (203 males and 210 females) underwent EETSA, and 315 patients underwent EETSA with NSF elevation. The mean patient age was 48.0 years. The total number of patients of NSF failure was 6 (overall rate: 1.61%, 6/315; flap elevation: 0.31%, 1/315; flap reconstruction: 15.1%, 5/33). Two patients had diabetes mellitus. One patient had cardiovascular problems. Five patients were elderly (>60 years; mean age: 70 years). Five patients had postoperative nasal infection. One patient underwent preoperative radiation therapy.
Nasoseptal flap is a usually safe and effective technique for skull base reconstruction. However, the management of patients with diabetes mellitus, cardiovascular problems, advanced age, postoperative nasal infection, and radiation therapy may require more attention to improve NSF survival.
在内镜下经鼻蝶窦入路（EETSA）后，使用带蒂鼻中隔瓣（NSF）重建颅底似乎具有优势。有一些报告评估了在EETSA中使用NSF导致瓣失败的原因。本研究的目的是评估NSF失败的围手术期危险因素。
患者系列研究。
在一家三级转诊中心对病历进行回顾性研究。
研究人群包括在2009年2月至2014年3月期间接受EETSA并掀起NSF的患者。作者回顾性地查阅了所有患者的病历，包括手术结果。
413例患者（203例男性和210例女性）接受了EETSA，其中315例患者接受了EETSA并掀起NSF。患者的平均年龄为48.0岁。NSF失败的患者总数为6例（总体发生率：1.61%，6/315；瓣掀起：0.31%，1/315；瓣重建：15.1%，5/33）。2例患者患有糖尿病。1例患者有心血管问题。5例患者为老年人（>60岁；平均年龄：70岁）。5例患者术后发生鼻腔感染。1例患者接受了术前放疗。
鼻中隔瓣是一种通常安全有效的颅底重建技术。然而，对于患有糖尿病、心血管问题、高龄、术后鼻腔感染和放疗的患者，可能需要更多关注以提高NSF的存活率。
