Alromaih Saud, Yaghmoor Faris, Alarifi Ibrahim, Alsaleh Saad, Alroqi Ahmad, Aloulah Mohammad, Almusa Abdulaziz, Ajlan Abdulrazag, Sumaily Ibrahim
Department of Otorhinolaryngology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Neurosurgery Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1344-1347. doi: 10.1007/s12070-021-02490-3. Epub 2021 Mar 6.
Reconstruction of the anterior part of the anterior skull base with a nasoseptal flap (NSF) is technically demanding. This challenge is mainly related to the real possible length of the flap. Herein, we describe a new technique for extending the NSF such that it can sufficiently cover the far anterior part of the anterior skull base. Three cadaveric heads were used for mucosal graft extension of the NSF. The graft was harvested from the other side, sutured to the NSF, then repositioned over the skull base after opening all the paranasal sinuses. Each head was operated by a rhinologist and a skull base surgeon. The study variables were the initial length of the NSF, the length of the graft harvested, the new length of the graft-extended NSF, and the length of the new graft-extended NSF from the nasal spine. The average length of the NSFs was 6.4 cm (± 0.2); that of the harvested grafts was 2.93 cm (± 0.1); that of the graft-extended NSF was 9.33 cm (± 0.4); and that of the graft-extended NSF from the nasal spine was 3.93 cm. The graft-extended NSF is an easy and extremely useful technique for the reconstruction of the far anterior parts of the skull base. However, further prospective studies on the clinical usefulness of this technique and its long-term results are yet to be performed. Level of evidence: IV.
使用鼻中隔瓣（NSF）重建前颅底前部在技术上具有挑战性。这一挑战主要与该瓣的实际可能长度有关。在此，我们描述一种延长NSF的新技术，使其能够充分覆盖前颅底的最前部。使用三个尸体头部进行NSF的黏膜移植延长。移植物取自另一侧，缝合到NSF上，然后在打开所有鼻窦后重新放置在前颅底上。每个头部由一名鼻科医生和一名颅底外科医生进行手术。研究变量包括NSF的初始长度、所取移植物的长度、移植延长后的NSF的新长度以及从鼻棘测量的移植延长后的NSF的长度。NSF的平均长度为6.4厘米（±0.2）；所取移植物的平均长度为2.93厘米（±0.1）；移植延长后的NSF的平均长度为9.33厘米（±0.4）；从鼻棘测量的移植延长后的NSF的平均长度为3.93厘米。移植延长后的NSF是一种用于重建颅底最前部的简单且极其有用的技术。然而，关于该技术临床实用性及其长期结果的进一步前瞻性研究尚未开展。证据级别：IV。
