Janakiram T N, Karunasagar Abhilasha
Department of Otorhinolaryngology and Skull Base Surgery, Royal Pearl Hospital, Tiruchchirappalli, Tamil Nadu India.
2Department of Otorhinolaryngology and Head and Neck Surgery, Sri Devaraj Urs Medical College, Kolar, Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):2151-2156. doi: 10.1007/s12070-019-01713-y. Epub 2019 Jul 26.
The evolution of expanded endoscopic skull base surgery has enabled development of minimally invasive approaches for resection of large skull base tumors with the nasoseptal flap proving to be an indispensable tool in skull base reconstruction. We here present our experience of sphenoid mucocele development after skull base reconstruction with the nasoseptal flap along with a comprehensive review of the limited literature on the same. With the expanding scope of endoscopic skull base surgery, the nasoseptal flap is increasingly being used for reconstruction. Despite adherence to standard recommendations and use of meticulous technique during flap placement, the potential risk of mucocele formation under the flap should always be borne in mind. In our experience, displacement of the flap pedicle could lead to ostial obstruction and mucocele formation. Hence, in addition to meticulous technique, a close follow up of such patients via nasal endoscopy or imaging is important to further our knowledge and understanding of the long-term effects and complications of this flap.
扩大内镜颅底手术的发展使得切除大型颅底肿瘤的微创方法得以开发，鼻中隔瓣已被证明是颅底重建中不可或缺的工具。我们在此介绍使用鼻中隔瓣进行颅底重建后蝶窦黏液囊肿形成的经验，并对相关的有限文献进行全面综述。随着内镜颅底手术范围的扩大，鼻中隔瓣越来越多地用于重建。尽管在瓣片放置过程中遵循了标准建议并采用了精细技术，但始终应牢记瓣片下形成黏液囊肿的潜在风险。根据我们的经验，瓣蒂移位可能导致开口阻塞和黏液囊肿形成。因此，除了精细技术外，通过鼻内镜检查或影像学对这些患者进行密切随访，对于增进我们对该瓣片长期影响和并发症的认识和理解非常重要。
