• Home
  • Practice Focus
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
    • How I Do It
    • TRIO Best Practices
  • Business of Medicine
    • Health Policy
    • Legal Matters
    • Practice Management
    • Tech Talk
    • AI
  • Literature Reviews
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Career
    • Medical Education
    • Professional Development
    • Resident Focus
  • ENT Perspectives
    • ENT Expressions
    • Everyday Ethics
    • From TRIO
    • The Great Debate
    • Letter From the Editor
    • Rx: Wellness
    • The Voice
    • Viewpoint
  • TRIO Resources
    • Triological Society
    • The Laryngoscope
    • Laryngoscope Investigative Otolaryngology
    • TRIO Combined Sections Meetings
    • COSM
    • Related Otolaryngology Events
  • Search

Can Posterior Septal Nasal Floor Mucosal Flap During Skull Base Reconstruction Repair Cerebrospinal Fluid Leaks?

by Linda Kossoff • April 18, 2022

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

Can use of a posterior septal nasal floor (PSNF) mucosal flap during skull base reconstruction repair cerebrospinal fluid (CSF) leaks with less risk of complication related to local donor site morbidity? 

BOTTOM LINE 

You Might Also Like

  • Ethmoidal Arteries with Pedicled Septal Floor Rotational Flaps Are Ideal for Endoscopic Skull Base Reconstruction
  • How To: Inferior Meatus Mucosal Flap for Septal Reconstruction and Resurfacing After Nasoseptal Flap Harvest
  • Surgical Repair of Spontaneous Cerebrospinal Fluid Leaks
  • Transorbital Endoscopic Repair a Feasible Approach for Select Patients with Frontal Sinus Cerebrospinal Fluid Leaks
Explore This Issue
April 2022

The PSNF flap provides a sizeable pedicled region for reconstruction comparable to other pedicled nasal flaps and appears to produce good postoperative outcomes with reduced donor site morbidity. 

BACKGROUND: Pedicled nasoseptal flaps (NSF) are the current workhorse in skull base reconstruction during endoscopic endonasal approaches (EEAs) to repair CSF leaks with modifications designed to extend the length or pedicle. However, there is a 27% complication rate related to local donor site morbidity, resulting in reduced quality of life (QOL). 

STUDY DESIGN: Cadaveric dissection, radiographic analysis, and retrospective case series. 

SETTING: Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn. 

SYNOPSIS: Researchers hypothesized that a nasal floor flap created with a pedicle traveling up the posterior septal wall would produce a pedicled flap similar to the NSF. They transformed the nasal floor free mucosal graft (FMG) harvest site into a pedicled flap, resulting in the pedicled SNF (PedSNF), and then harvested from multiple cadaver specimens. Flap dimensions measured via computed tomography demonstrated that both right and left flaps were feasible for reconstruction. Researchers noted that the flap demonstrated good arc rotation along its pedicle following complete dissection. For the case series, a total of 15 patients underwent reconstruction of sellar and/ or planum defects using the PedSNF technique. A CSF leak was present intraoperatively in eight cases. In all 15 cases, surgeons were able to successfully repair the defect without difficulty. There appeared to be low morbidity associated with nasal floor defect. Authors concluded that the PSNF technique provides a sizable pedicled region and can be applied for the reconstruction of sellar and suprasellar defects in the presence of CSF leaks. Study limitations included limited patient follow-up. 

CITATION: Bowen AJ, Eltahir A, Goates AJ, et al. The posterior septal nasal floor mucosal flap for cranial base reconstruction [published online ahead of print February 28, 2022]. Laryngoscope. 

Filed Under: Head and Neck, Head and Neck, Literature Reviews, Practice Focus Tagged With: clinical outcomesIssue: April 2022

You Might Also Like:

  • Ethmoidal Arteries with Pedicled Septal Floor Rotational Flaps Are Ideal for Endoscopic Skull Base Reconstruction
  • How To: Inferior Meatus Mucosal Flap for Septal Reconstruction and Resurfacing After Nasoseptal Flap Harvest
  • Surgical Repair of Spontaneous Cerebrospinal Fluid Leaks
  • Transorbital Endoscopic Repair a Feasible Approach for Select Patients with Frontal Sinus Cerebrospinal Fluid Leaks

The Triological SocietyENTtoday is a publication of The Triological Society.

Polls

Have you invented or patented something that betters the field of otolaryngology?

View Results

Loading ... Loading ...
  • Polls Archive

Top Articles for Residents

  • Applications Open for Resident Members of ENTtoday Edit Board
  • How To Provide Helpful Feedback To Residents
  • Call for Resident Bowl Questions
  • New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World
  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Popular this Week
  • Most Popular
  • Most Recent
    • Otolaryngologists as Entrepreneurs: Transforming Patient Care And Practice

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Physician Handwriting: A Potentially Powerful Healing Tool

    • Continued Discussion And Engagement Are Essential To How Otolaryngologists Are Championing DEI Initiatives In Medicine

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Complications for When Physicians Change a Maiden Name

    • Physician Handwriting: A Potentially Powerful Healing Tool
    • Leaky Pipes—Time to Focus on Our Foundations
    • You Are Among Friends: The Value Of Being In A Group
    • How To: Full Endoscopic Procedures of Total Parotidectomy
    • How To: Does Intralesional Steroid Injection Effectively Mitigate Vocal Fold Scarring in a Rabbit Model?

Follow Us

  • Contact Us
  • About Us
  • Advertise
  • The Triological Society
  • The Laryngoscope
  • Laryngoscope Investigative Otolaryngology
  • Privacy Policy
  • Terms of Use
  • Cookies

Wiley

Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1559-4939