Kim Matthew, Otten Marc, Overdevest Jonathan B, Gudis David A
Division of Rhinology and Anterior Skull Base Surgery, Department of Otolaryngology - Head and Neck Surgery, New York-Presbyterian Hospital, New York, New York.
Department of Neurological Surgery, The Neurological Institute of New York, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York.
Oper Neurosurg (Hagerstown). 2021 Jan 13;20(2):E112-E115. doi: 10.1093/ons/opaa304.
The vascularized nasoseptal flap (NSF) is a pillar of contemporary endoscopic skull base reconstruction. The pedicle for the NSF is supplied by the posterior septal branch of the sphenopalatine artery, which courses along the arch of the choana and sphenoid rostrum before entering the nasal septum. Resection or mobilization of this region is necessary for surgical access to the clivus.
To describe a technique for preserving bilateral NSF pedicles during endoscopic endonasal resection of the clivus, thereby safeguarding availability of the flaps for future skull base repair needs.
Report of operative technique with video demonstration.
This technique for NSF preservation allows for wide access to the clivus while saving the future option for vascularized flap repairs of skull base defects. The patient in whom we demonstrate this technique underwent complete resection of her clivus without cerebrospinal fluid leak and with preservation of both NSF pedicles.
The "rescue strip" technique for endonasal endoscopic clival surgery preserves the bilateral NSF pedicles for future use without compromising surgical access to the clivus.
带血管蒂鼻中隔瓣（NSF）是当代内镜下颅底重建的支柱。NSF的蒂由蝶腭动脉的后鼻中隔支供应，该动脉沿后鼻孔弓和蝶骨 Rostrum 走行，然后进入鼻中隔。为了手术进入斜坡，该区域的切除或游离是必要的。
描述一种在内镜下经鼻切除斜坡时保留双侧NSF蒂的技术，从而保障该瓣用于未来颅底修复需求的可用性。
通过视频演示报告手术技术。
这种保留NSF的技术允许广泛进入斜坡，同时保留了未来用于颅底缺损带血管蒂瓣修复的选择。我们展示该技术的患者斜坡完全切除，无脑脊液漏，且双侧NSF蒂均得以保留。
经鼻内镜斜坡手术的“挽救条带”技术保留双侧NSF蒂以备将来使用，而不影响进入斜坡的手术操作。
