Anania Pasquale, Ceraudo Marco, Prior Alessandro, Fiaschi Pietro, Zona Gianluigi, Rikki-Canevari Frank, Rossi Diego Criminelli
Department of Neurosurgery, Policlinico San Martino Hospital, IRCCS for Oncology and Neuroscience , Genoa, Italy.
Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Maternal and Children (DINOGMI), University of Genoa, Genoa, Italy.
Iran J Otorhinolaryngol. 2021 Nov;33(119):361-367. doi: 10.22038/IJORL.2021.54687.2866.
Transpterygoid approach is an expanded endonasal approach (EEA) that allows surgical access to the medial infratemporal fossa, to the skull base area of petrous bone and to the Meckel's cave. During this approach, a sacrifice of sphenopalatine artery is often required, leading to the need of contralateral Hadad-Bassagasteguy flap (HBF) or alternative reconstructive techniques.
We report a case of spontaneous CSF leak due to a meningo-encephalocele in the left lateral recess of sphenoid sinus, in which an ispilateral nasoseptal flap was harvest and sphenopalatine artery was preserved.
We described the surgical technique adopted to preserve the ipsilateral nasoseptal vascular pedicle during transpterygoid approach and we performed a review of the pertinent literature.
Wide exposure of the pterygoid base through transpterygoid approach could be obtained preserving the sphenopalatine artery, allowing skull base reconstruction with ipsilateral nasoseptal flap.
经翼突入路是一种扩大经鼻入路（EEA），可用于手术进入颞下窝内侧、岩骨颅底区域及 Meckel 腔。在此入路过程中，通常需要牺牲蝶腭动脉，这就需要对侧的 Hadad-Bassagasteguy 皮瓣（HBF）或其他重建技术。
我们报告一例因蝶窦左侧隐窝脑膜脑膨出导致的自发性脑脊液漏病例，术中采用同侧鼻中隔皮瓣并保留了蝶腭动脉。
我们描述了在经翼突入路过程中保留同侧鼻中隔血管蒂所采用的手术技术，并对相关文献进行了综述。
经翼突入路可在保留蝶腭动脉的情况下广泛暴露翼突基部，从而允许使用同侧鼻中隔皮瓣进行颅底重建。
