Santamaría Alfonso, Langdon Cristóbal, López-Chacon Mauricio, Cordero Arturo, Enseñat Joaquim, Carrau Ricardo, Bernal-Sprekelsen Manuel, Alobid Isam
Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain.
Department of Neurosurgery, Hospital Clinic, University of Barcelona, Barcelona, Spain.
Laryngoscope. 2017 Nov;127(11):2482-2489. doi: 10.1002/lary.26574. Epub 2017 Mar 21.
OBJECTIVES/HYPOTHESIS: To evaluate the versatility of the pericranial flap (PCF) to reconstruct the ventral skull base, using the frontal sinus as a gate for its passage into the sinonasal corridor "money box approach."
Anatomic-radiological study and case series.
Various approaches and their respective defects (cribriform, transtuberculum, clival, and craniovertebral junction) were completed in 10 injected specimens. The PCF was introduced into the nose through the uppermost portion of the frontal sinus (money box approach). Computed tomography (CT) scans (n = 50) were used to measure the dimensions of the PCF and the skull base defects. The vertical projection of the external ear canal was used as the reference point to standardize the incisions for the PCF.
The surface area and maximum length of the PCF were 121.5 ± 19.4 cm and 18.3 ± 1.3 cm, respectively. Using CT scans, we determined that to reconstruct defects secondary to transcribriform, transtuberculum, clival, and craniovertebral approaches, the PCF distal incision must be placed respectively at -3.7 ± 2.0 cm (angle -17.4 ± 8.5°), -0.2 ± 2.0 cm (angle -1.0 ± 9.3°), +5.5 ± 2.3 cm (angle +24.4 ± 9.7°), +8.4 ± 2.4 cm (angle +36.6 ± 11.5°), as related to the reference point. Skull base defects in our clinical cohort (n = 6) were completely reconstructed uneventfully with the PCF.
The PCF renders enough surface area to reconstruct all possible defects in the ventral and median skull base. Using the uppermost frontal sinus as a gateway into the nose (money box approach) is feasible and simple.
NA. Laryngoscope, 127:2482-2489, 2017.
目的/假设：使用额窦作为进入鼻窦通道的“钱盒入路”，评估颅骨膜瓣（PCF）重建腹侧颅底的多功能性。
解剖学-放射学研究和病例系列。
在10个注射标本中完成各种入路及其各自的缺损（筛板、结节间、斜坡和颅颈交界区）。通过额窦的最上部将PCF引入鼻腔（钱盒入路）。使用计算机断层扫描（CT）扫描（n = 50）测量PCF和颅底缺损的尺寸。以外耳道的垂直投影作为参考点来标准化PCF的切口。
PCF的表面积和最大长度分别为121.5±19.4 cm和18.3±1.3 cm。使用CT扫描，我们确定，为了重建继发于筛板、结节间、斜坡和颅颈交界区入路的缺损，与参考点相关，PCF远端切口必须分别置于-3.7±2.0 cm（角度-17.4±8.5°）、-0.2±2.0 cm（角度-1.0±9.3°）、+5.5±2.3 cm（角度+24.4±9.7°）、+8.4±2.4 cm（角度+36.6±11.5°）处。我们临床队列中的颅底缺损（n = 6）使用PCF均顺利完全重建。
PCF提供了足够的表面积来重建腹侧和正中颅底的所有可能缺损。使用额窦最上部作为进入鼻腔的通道（钱盒入路）是可行且简单的。
无。《喉镜》，2017年，第127卷：2482 - 2489页。
