Composite Chondromucosal Nasoseptal Flap for Reconstruction of Suprasellar Defects

World Neurosurg. 2021 May:149:11-14. doi: 10.1016/j.wneu.2021.01.137. Epub 2021 Feb 5.

Abstract

Background: The pedicled nasoseptal flap (NSF) is the mainstay for endoscopic skull base reconstruction. We present a novel technique using a semirigid chondromucosal NSF that improves the reinforcement and protection of intracranial structures.

Methods: Composite NSFs were performed to repair intraoperative high-flow cerebrospinal fluid leaks in 2 patients who had undergone endoscopic endonasal resection of a suprasellar mass. The surgical technique and postoperative outcomes are described.

Results: The flaps were sufficient for defect coverage, and the patients did not experience any cerebrospinal fluid leak in the immediate and delayed postoperative periods. No complications related to the composite flap had developed.

Conclusions: The composite chondromucosal NSF is a reliable reconstruction option for select ventral cranial base reconstruction cases with the potential to improve the protection of intracranial structures. Additional surgical cases and longer follow-up are required for a better assessment of long-term outcomes.

Keywords: Composite flap; Cranial base defect; Endoscopic endonasal reconstruction; Nasoseptal flap; Suprasellar mass.

Publication types

  • Case Reports
  • Technical Report

MeSH terms

  • Adolescent
  • Aged, 80 and over
  • Cerebral Ventricle Neoplasms / diagnostic imaging
  • Cerebral Ventricle Neoplasms / surgery
  • Female
  • Humans
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / surgery
  • Meningioma / diagnostic imaging
  • Meningioma / surgery
  • Nasal Mucosa / diagnostic imaging
  • Nasal Mucosa / surgery
  • Nasal Septum / diagnostic imaging
  • Nasal Septum / surgery*
  • Neurosurgical Procedures / methods*
  • Plastic Surgery Procedures / methods*
  • Skull Base / diagnostic imaging
  • Skull Base / surgery*
  • Surgical Flaps / surgery*
  • Third Ventricle / diagnostic imaging
  • Third Ventricle / surgery