Reconstruction of skull base bone defects using an in situ bone flap after endoscopic endonasal transplanum-transtuberculum approaches.

Szczegóły
Abstrakt

Tytuł:: Reconstruction of skull base bone defects using an in situ bone flap after endoscopic endonasal transplanum-transtuberculum approaches.
Autorzy:: Jin B; Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuzhong District, Chongqing, People's Republic of China.
Wang XS; Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuzhong District, Chongqing, People's Republic of China.
Huo G; Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuzhong District, Chongqing, People's Republic of China.
Mou JM; Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuzhong District, Chongqing, People's Republic of China.
Yang G; Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuzhong District, Chongqing, People's Republic of China. yg_.
Źródło:: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2020 Jul; Vol. 277 (7), pp. 2071-2080. Date of Electronic Publication: 2020 Mar 16.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Heidelberg : Springer International, c1990-
MeSH Terms:: Plastic Surgery Procedures*
Skull Base Neoplasms*/surgery
Cerebrospinal Fluid Leak/etiology ; Cerebrospinal Fluid Leak/surgery ; Endoscopy ; Humans ; Retrospective Studies ; Skull Base/surgery ; Surgical Flaps/surgery
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Contributed Indexing:: Keywords: Endoscopic endonasal transplanum-transtuberculum approaches; High-flow CSF leakage; In situ bone flap; Skull base reconstruction
Entry Date(s):: Date Created: 20200318 Date Completed: 20210427 Latest Revision: 20221207
Update Code:: 20240105
DOI:: 10.1007/s00405-020-05911-1
PMID:: 32180016
: Czasopismo naukowe

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Purpose: The creation of bone flaps which can be later repositioned and fixed in situ for repairing the bone defects during the endoscopic endonasal approaches (EEAs)-similar to transcranial craniotomies-is still a challenge. We present an in situ bone flap (ISBF) closure for the repair of bone defects after endoscopic endonasal transplanum-transtuberculum approaches (EETAs).
Methods: A retrospective analysis of consecutive patients who underwent the EETAs between January 2016 and February 2019 was performed. According to whether or not to use ISBF for skull base reconstruction, these patients were divided into the ISBF group or the non-ISBF group.
Results: Of 47 patients in the ISBF group, only one patient (2.1%) developed postoperative cerebrospinal fluid (CSF) leakage, yielding a significantly lower leakage rate in the ISBF group than in the non-ISBF group (6 of 38, 15.8%, P = 0.042). Besides, when only comparing cases of hydrocephalus in the two groups, the CSF leakage rate in the ISBF group was 8.3% (1/12), which was still significantly lower than that in the non-ISBF group (62.5%, 6/8) (P = 0.018). Postoperative CSF leakages in both groups were successfully treated with lumbar drainage alone, and no cases of injury to the internal carotid arteries or optic nerves occurred in either group.
Conclusions: An ISBF closure similar to transcranial craniotomies with repositioning bone flap in situ-is feasible, safe, and reliable. The ISBF closure combining with a pedicled nasoseptal flap (PNSF) provides the cranial base surgeon with an additional repair method that has demonstrated effectiveness at facilitating a more stable and durable reconstruction and reducing CSF leaks.

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