Pedicled frontal periosteal rescue flap via eyebrow incision for skull base reconstruction (SevEN-002)

被引:1
|
作者
Jang, Chang Ki [1 ,12 ]
Park, Soo Jeong [3 ]
Kim, Eui Hyun [2 ,4 ,5 ]
Cho, Jin Mo [6 ]
Moon, Ju Hyung [2 ,4 ,5 ]
Sung, Kyoung Su [7 ]
Hong, Je Beom [8 ]
Lim, Jaejoon Joon [9 ]
Na, Minkyun [2 ]
Hong, Chang-Ki [10 ]
Roh, Tae Hoon [11 ]
Oh, Jiwoong [2 ]
机构
[1] Yonsei Univ, Yongin Severance Hosp, Dept Neurosurg, Coll Med, Yongin, Gyeonggi Do, South Korea
[2] Yonsei Univ, Dept Neurosurg, Coll Med, 50 Yonsei Ro, Seoul 120752, South Korea
[3] Ewha Womans Univ Med Ctr, Seoul Hosp, Dept Neurosurg, Seoul, South Korea
[4] Yonsei Univ, Brain Tumor Ctr, Coll Med, Seoul, South Korea
[5] Yonsei Univ, Pituitary Tumor Ctr, Coll Med, Seoul, South Korea
[6] Catholic Kwandong Univ, Dept Neurosurg, Coll Med, Incheon, South Korea
[7] Dong A Univ, Dept Neurosurg, Coll Med, Busan, South Korea
[8] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Neurosurg, Sch Med, Seoul, South Korea
[9] CHA Univ, Coll Med, Bundang CHA Med Ctr, Dept Neurosurg, Seongnam, South Korea
[10] Univ Ulsan, Asan Med Ctr, Dept Neurosurg, Coll Med, 88,Olymp Ro 43 Gil, Seoul 05505, South Korea
[11] Ajou Univ, Dept Neurosurg, Coll Med, Suwon, South Korea
[12] Kangwon Natl Univ, Coll Med, Chunchon, South Korea
关键词
CSF leak; Endonasal approach; Endoscopic surgery; Pericranial flap; Skull base; ENDOSCOPIC ENDONASAL APPROACH; TRANSSPHENOIDAL SURGERY; ANTERIOR;
D O I
10.1186/s12893-022-01590-3
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose Cerebrospinal fluid (CSF) leakage is one of the major complications after endoscopic endonasal surgery. The reconstructive nasoseptal flap is widely used to repair CSF leakage. However, it could not be utilized in all cases; thus, there was a need for an alternative. We developed a pericranial rescue flap that could cover both sellar and anterior skull base defects via the endonasal approach. A modified surgical technique that did not violate the frontal sinus and cause cosmetic problems was designed using the pericranial rescue flap. Methods We performed 12 cadaveric dissections to investigate the applicability of the lateral pericranial rescue flap. An incision was made, extending from the middle to the lateral part of the eyebrow. The pericranium layer was dissected away from the galea layer, from the supraorbital region towards the frontoparietal region. With endoscopic assistance, the periosteal flap was raised, the flap base was the pericranium layer at the eyebrow incision. After a burr-hole was made in the supraorbital bone, the pericranial flap was inserted via the intradural or extradural pathway. Results The mean size of the pericranial flap was 11.5 cm x 3.2 cm. It was large enough to cross the midline and cover the dural defects of the anterior skull base, including the sellar region. Conclusion We demonstrated a modified endoscopic technique to repair the anterior skull base defects. This minimally invasive pericranial flap may resolve neurosurgical complications, such as CSF leakage.
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页数:8
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