Carnevale C, Tomás-Barberán M, Til-Pérez G, Ibañez-Domínguez J, Arancibia-Tagle D, Rodríguez-Villalba R, Sarría-Echegaray P
Department of Otolaryngology and Head and Neck Surgery, Son Espases University Hospital, Palma de Mallorca, Spain.
Department of Neurosurgery, Son Espases University Hospital, Palma de Mallorca, Spain.
J Laryngol Otol. 2019 Oct;133(10):889-894. doi: 10.1017/S0022215119001841. Epub 2019 Sep 9.
The indications for expanded endoscopic transnasal approaches continue to increase, with more complex skull base defects needing to be repaired. This study reviews the management of large anterior skull base defects with opening of the sellar diaphragm.
A prospective analysis of endonasal endoscopic surgery carried out at Son Espases University Hospital between January 2013 and December 2018 was performed. The analysis included only the cases with a significative intra-operative cerebrospinal fluid leak. In all cases, reconstruction was performed by combining the gasket seal technique with a pedicled mucosal endonasal flap.
Twenty-eight patients were included. The mucoperiosteal nasoseptal flap, the lateral wall flap and the middle turbinate flap were used in 13, 8 and 7 patients, respectively, combined with the gasket seal technique. One case of post-operative cerebrospinal fluid leak was observed (3.57 per cent).
The combination of a gasket seal with an endonasal mucosal flap is an excellent technique for repairing large anterior skull base defects.
随着需要修复的颅底缺损越来越复杂，扩大经鼻内镜手术的适应证持续增加。本研究回顾了经蝶鞍膈开放修复大型前颅底缺损的治疗方法。
对2013年1月至2018年12月在Son Espases大学医院进行的鼻内镜手术进行前瞻性分析。该分析仅纳入术中出现明显脑脊液漏的病例。所有病例均采用垫片封闭技术联合带蒂鼻内黏膜瓣进行重建。
共纳入28例患者。分别有13例、8例和7例患者使用了鼻中隔黏骨膜瓣、侧壁瓣和中鼻甲瓣，并联合垫片封闭技术。观察到1例术后脑脊液漏（3.57%）。
垫片封闭联合鼻内黏膜瓣是修复大型前颅底缺损的一种优秀技术。
