Also part of the UPMC family:
Also part of the UPMC family:

Endoscopic Skull Base Surgery and Reconstruction

UPMC Content 3

Background

In patients with large dural defects of the anterior and ventral skull base after endonasal skull base surgery, there is a significant risk of a postoperative cerebrospinal fluid leak after reconstruction. Endoscopic reconstruction with vascularized tissue is desirable to facilitate rapid healing, especially in irradiated patients.

Methods

We developed a neurovascular pedicled flap of the nasal septum mucoperiosteum and mucoperichondrium based on the nasoseptal artery, a branch of the posterior septal artery (Hadad-Bassagasteguy flap [HBF]). A retrospective review of patients undergoing endonasal skull base surgery at the University of Rosario, Argentina, and the University of Pittsburgh Medical Center was performed to identify patients who were reconstructed with a vascularized septal mucosal flap.

Results

Forty-three patients undergoing endonasal cranial base surgery were repaired with the septal mucosal flap. Two patients with postoperative cerebrospinal fluid leaks (5%) were successfully treated with focal fat grafts. We encountered no infectious or wound complications in this series of patients. One patient experienced a posterior nose bleed from the posterior nasal artery. This was controlled with electrocautery and the flap blood supply was preserved.

Conclusion

The HBF is a versatile and reliable endoscopic reconstructive technique for defects of the anterior, middle, clival, and parasellar skull base. Its use has resulted in a sharp decrease in the incidence of postoperative cerebrospinal fluid leaks after endonasal skull base surgery and is recommended for the reconstruction of large dural defects and when postoperative radiation therapy is anticipated. Treatment and results may not be representative of all similar cases.

Read the full article: A Novel Reconstructive Technique After Endoscopic Expanded Endonasal Approaches: Vascular Pedicle Nasoseptal Flap (PDF)

Treatment and results may not be representative of all similar cases.‚Äč

Endoscopic Endonasal Approach (EEA)
Pituitary Tumor Removal Using the Endoscopic Endonasal Approach (EEA) at UPMC

Find a Doctor

Browse UPMC doctors and medical professionals to find the care that's right for you. Customize your search by specialty, zip code, last name, and more.


Visit the UPMC Find a Doctor website.
Make an Appointment

Find important information on scheduling your appointment or finding a doctor or service that meets your needs.


Request an appointment now.
Find a Location

Browse addresses and contact information for our network of hospitals, specialty care practices, and community health locations.


Find a UPMC location near you.
Pay Your Bill

Learn more about how to pay your UPMC bill. Find resources including payment methods and contact information for assistance.


Pay your bill now.
Find a Career

Advance your career with UPMC. Discover our latest job listings and learn about our values and career pathways.


Find your ideal career at UPMC.