Offi Martina, Mattogno Pier Paolo, D'Onofrio Ginevra Federica, Serioli Simona, Valeri Federico, Della Pepa Giuseppe Maria, Arena Vincenzo, Parrilla Claudio, Chiloiro Sabrina, D'Argento Francesco, Gessi Marco, Pedicelli Alessandro, Lauretti Liverana, Paludetti Gaetano, Galli Jacopo, Olivi Alessandro, Rigante Mario, Doglietto Francesco
Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
J Clin Med. 2024 Nov 27;13(23):7217. doi: 10.3390/jcm13237217.
The temporoparietal fascia flap (TPFF) has recently emerged as an option for skull base reconstruction in endoscopic transnasal surgery when vascularized nasal flaps are not available. This study provides a systematic literature review of its use in skull base surgery and describes a novel cohort of patients. PRISMA guidelines were used for the review. Patients undergoing skull base reconstruction with TPFF in our center from May 2022 to April 2024 were retrospectively included. Data were collected on pre- and post-operative clinical and radiological features, histology, surgical procedures, and complications. Sixteen articles were selected, comprising 42 patients who underwent TPFF reconstruction for treatment of complex skull base pathologies. In total, 5 of 358 patients (0.9%) who underwent tumor resection via endoscopic transanal surgery in the study period in our institution required TPFF. All had been previously treated with surgery and radiation therapy for different pathologies (three chordomas, one giant pituitary neuroendocrine tumor (PitNET), and one sarcoma). Post-operative complications included CSF leak, which resolved after flap revision, and an internal carotid artery pseudoaneurysm requiring endovascular embolization. TPFF is an effective option for skull base reconstruction in complex cases and should be part of the armamentarium of the skull base surgeon.
当无法使用带血管蒂的鼻瓣时，颞顶筋膜瓣（TPFF）最近已成为内镜经鼻手术中颅底重建的一种选择。本研究对其在颅底手术中的应用进行了系统的文献综述，并描述了一组新的患者队列。本综述采用PRISMA指南。回顾性纳入了2022年5月至2024年4月在我们中心接受TPFF颅底重建的患者。收集了术前和术后的临床和影像学特征、组织学、手术过程及并发症的数据。共筛选出16篇文章，包括42例接受TPFF重建以治疗复杂颅底病变的患者。在我们机构研究期间，通过内镜经肛门手术进行肿瘤切除的358例患者中，共有5例（0.9%）需要TPFF。所有患者此前均因不同病变接受过手术和放射治疗（3例脊索瘤、1例巨大垂体神经内分泌肿瘤（PitNET）和1例肉瘤）。术后并发症包括脑脊液漏，经皮瓣修复后得以解决，以及1例需要血管内栓塞的颈内动脉假性动脉瘤。TPFF是复杂病例颅底重建的有效选择，应成为颅底外科医生的工具之一。
