Supplementary Material for: Pedicled Extranasal Flaps in Skull Base Reconstruction
Kim G.G.
Hang A.X.
Mitchell C.A.
Zanation A.M.
10.6084/m9.figshare.5532229.v1
https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Pedicled_Extranasal_Flaps_in_Skull_Base_Reconstruction/5532229
<p>Cerebrospinal fluid (CSF) leaks most commonly arise during or after
skull base surgery, although they occasionally present spontaneously.
Recent advances in the repair of CSF leaks have enabled endoscopic
endonasal surgery to become the preferred option for management of skull
base pathology. Small defects (<1 cm) can be repaired by
multilayered free grafts. For large defects (>3 cm), pedicled
vascular flaps are the repair method of choice, resulting in much lower
rates of postoperative CSF leaks. The pedicled nasoseptal flap (NSF)
constitutes the primary reconstructive option for the vast majority of
skull base defects. It has a large area of potential coverage and high
rates of success. However, preoperative planning is required to avoid
sacrificing the NSF during resection. In cases where the NSF is
unavailable, often due to tumor involvement of the septum or previous
resection removing or compromising the flap, other flaps may be
considered. These flaps include intranasal options – inferior turbinate
or middle turbinate flaps – as well as regional pedicled flaps:
pericranial flap, temporoparietal fascial flap, or palatal flap. More
recently, novel alternatives such as the pedicled facial buccinator flap
and the pedicled occipital galeopericranial flap have been added to the
arsenal of options for skull base reconstruction. Characteristics of
and appropriate uses for each flap are described.</p>
2017-10-24 13:33:16
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