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- Title
Posterior Pedicle Lateral Nasal Wall Flap: A New Reconstructive Technique for Large Defects of the Skull Base.
- Authors
Rivera-Serrano, Carlos M; Bassagaisteguy, Luis; Hadad, Gustavo; Carrau, Ricardo; Kelly, Dan; Prevedello, Daniel; Fernandez-Miranda, Juan; Kassam, Amin
- Abstract
Objectives: Indications for expanded endoscopic approaches continue to grow, resulting in larger and more complex skull base defects. Reconstructive developments, however, have lagged our extirpative capabilities. As the complexity of clinical scenarios escalate, challenging our current reconstructive strategies, we are compelled to develop alternative techniques. In this article we demonstrate the anatomical basis for a new posterior pedicled lateral wall flap (Carrau-Hadad or C-H flap) for the reconstruction of median skull base defects, and present our early clinical experience. Study Design: Anatomical description. Technical report. Feasibility. Methods: Using a cadaveric model we designed a posterior pedicle flap comprising the nasal inferolateral wall mucoperiosteum. We applied this information clinically, to reconstruct transmural skull base defects Results: In our cadaveric model, we harvested and transposed C-H flaps into various defects of the planum sphenoidale, sella turcica, clivus and nasopharynx. Then, we used the C-H flap in four patients, successfully reconstructing their clival (n=3) and sellar (n=1) surgical defects. All patients healed uneventfully. Conclusions: Our anatomical study and early clinical experience support the use of the posterior pedicle lateral nasal wall flap to reconstruct large cranial base defects in properly selected patients.
- Subjects
SKULL base; HUMAN skeleton; PEDICLE flaps (Surgery); NASAL bone; POSTERIOR cranial fossa; NASOPHARYNX; SURGERY
- Publication
Laryngoscope, 2011, Vol 121, Issue S5, pS354
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1002/lary.22310