scholarly journals A Case of Endonasal Endoscopic Skull Base Repair Using Nasoseptal Flap after Revision Transsphenoidal Surgery for Pituitary Adenoma

2019 ◽  
Vol 30 (2) ◽  
pp. 270-275
Author(s):  
Yong Tae Cho ◽  
Ji Sun Kim
2015 ◽  
Vol 73 (7) ◽  
pp. 611-615 ◽  
Author(s):  
Yasunori Fujimoto ◽  
Leonardo Balsalobre ◽  
Fábio P. Santos ◽  
Eduardo Vellutini ◽  
Aldo C. Stamm

Objective The purpose of this study was to describe the endoscopic combined “transseptal/transnasal” approach with a pedicled nasoseptal flap for pituitary adenoma and skull base reconstruction, especially with respect to cerebrospinal fluid (CSF) fistula.Method Ninety-one consecutive patients with pituitary adenomas were retrospectively reviewed. All patients underwent the endoscopic combined “transseptal/transnasal” approach by the single team including the otorhinolaryngologists and neurosurgeons. Postoperative complications related to the flap were analyzed.Results Intra- and postoperative CSF fistulae were observed in 36 (40%) and 4 (4.4%) patients, respectively. Among the 4 patients, lumbar drainage and bed rest healed the CSF fistula in 3 patients and reoperation for revision was necessary in one patient. Other flap-related complications included nasal bleeding in 3 patients (3.3%).Conclusion The endoscopic combined “transseptal/transnasal” approach is most suitable for a two-surgeon technique and a pedicled nasoseptal flap is a reliable technique for preventing postoperative CSF fistula in pituitary surgery.


2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Mihir Patel ◽  
Robert Taylor ◽  
Trevor Hackman ◽  
Deanna Sasaki-Adams ◽  
Matthew Ewend ◽  
...  

Author(s):  
Anat Wengier ◽  
Dan Fliss ◽  
Zvi Ram ◽  
Nevo Margalit ◽  
Avraham Abergel

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Adam Zanation ◽  
Carl Snyderman ◽  
Ricardo Carrau ◽  
Paul Gardner ◽  
Daniel Prevedello ◽  
...  

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Seth Brown ◽  
Abtin Tabaee ◽  
Vijay Anand ◽  
Ameet Singh ◽  
Theodore Schwartz

2016 ◽  
Vol 17 (3) ◽  
pp. 371-377 ◽  
Author(s):  
Jeffrey C. Rastatter ◽  
Patrick C. Walz ◽  
Tord D. Alden

The authors of this report present a pediatric case involving the use of a tunneled temporoparietal fascia flap to reconstruct a skull base defect for a multiply recurrent clival chordoma and cerebrospinal fluid leak, demonstrate the surgical technique through illustrations and intraoperative photos, and review the pertinent literature. A 9-year-old female patient underwent extensive clival chordoma resection via both the endoscopic and open approaches, which ultimately exhausted the bilateral nasoseptal flaps and other intranasal reconstructive options. Following proton beam radiation and initiation of chemotherapy, tumor recurrence was managed with further endoscopic resection, which was complicated by a recalcitrant cerebrospinal fluid leak. A tunneled temporoparietal fascia flap was used to provide vascular tissue to augment an endoscopic repair of the leak and reconstruction of the skull base. While the nasoseptal flap remains the workhorse for many pediatric and adult endoscopic skull base reconstructions, the tunneled temporoparietal fascia flap has a demonstrated efficacy in adults when the nasoseptal flap and other intranasal flaps are unavailable. This report documents a pediatric case, serving as a step toward establishing this technique in the pediatric population.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xing Huang ◽  
Ni Fan ◽  
Hai-jun Wang ◽  
Yan Zhou ◽  
Xudong Li ◽  
...  

AbstractThe application of 3D printing in planning endoscopic endonasal transsphenoidal surgery is illustrated based on the analysis of patients with intracranial skull base diseases who received treatment in our department. Cranial computed tomography/magnetic resonance imaging data are attained preoperatively, and three-dimensional reconstruction is performed using MIMICS (Materialise, Leuven, Belgium). Models of intracranial skull base diseases are printed using a 3D printer before surgery. The models clearly demonstrate the morphologies of the intracranial skull base diseases and the spatial relationship with adjacent large vessels and bones. The printing time of each model is 12.52–15.32 h, and the cost ranges from 900 to 1500 RMB. The operative approach was planned in vitro, and patients recovered postoperatively well without severe complications or death. In a questionnaire about the application of 3D printing, experienced neurosurgeons achieved scores of 7.8–8.8 out of 10, while unexperienced neurosurgeons achieved scores of 9.2–9.8. Resection of intracranial skull base lesions is demonstrated to be well assisted by 3D printing technique, which has great potential in disclosing adjacent anatomical relationships and providing the required help to clinical doctors in preoperative planning.


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