ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Ethmoidal Arteries with Pedicled Septal Floor Rotational Flaps Are Ideal for Endoscopic Skull Base Reconstruction

by Amy E. Hamaker • December 9, 2019

  • Tweet
  • Email
Print-Friendly Version

How well does a septal floor rotational flap pedicled on ethmoidal arteries for endoscopic skull base reconstruction work in certain cases?

Bottom line: Ethmoidal arteries with pedicled septal floor rotational flaps, with their strong blood supply and large coverage area, are ideal replacements for the nasoseptal flap (NSF). The flap’s dimension, pedicle, and flexibility, as well as convenience of use, should all be considered.

You Might Also Like

  • Free Flap Surgery Viable Choice for Mandible Reconstruction
  • Vascularized Flaps Useful in Reducing PCF
  • Endoscopic Skull Base Surgery Indications Continue to Expand
  • Stereotactic Radiotherapy Treats Skull Base Tumors: Part 2 of
Explore This Issue
December 2019

Background: Expanded endonasal approaches have dramatically changed how skull base surgery is performed, and NSF has significantly improved skull base reconstruction. However, challenges remain when the pterygopalatine artery is invaded by tumors; when it must be sacrificed to approach the lateral sphenoidal recess; when late-occurrence leak occurs in the sella after transsphenoidal surgery; and also when the leak is on the posterior wall of the frontal sinus, which is too distant for NSF to reach.

Study design: Retrospective case series of 19 patients who underwent skull base reconstruction with a septal floor rotational flap pedicled on the ethmoidal arteries.

Setting: Department of Otorhinolaryngology–Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China.

Synopsis: Expanded endonasal approaches have significantly improved the treatment of skull base malignancies and cerebrospinal fluid (CSF) leak. One of the consequent challenges is how to choose an appropriate graft to reconstruct the skull base defects for an impermeable dural seal. When the nasoseptal flap was not available or was useless, the authors adopted septal floor rotational flaps based on ethmoidal arteries to repair skull base defects, adopting anterior or posterior ethmoidal artery pedicled flaps, according to the location of the leak. All flaps survived, and no CSF leak occurred or recurred during three months to four years of follow-up. None of the patients developed necrosis of the flap after adjuvant radiotherapy, and there were no recurrences of malignant diseases as of the study date. One patient with a postoperative CSF leak after pituitary tumor surgery and meningitis underwent epistaxis two times as well as dysfunction (Figure 1).

Citation: Mao S, Li M, Li D, et al. Septal floor rotational flap pedicled on ethmoidal arteries for endoscopic skull base reconstruction. Laryngoscope. 2019;129:2696–2701.

Filed Under: Head and Neck, Literature Reviews Tagged With: rotational flaps, skull base reconstructionIssue: December 2019

You Might Also Like:

  • Free Flap Surgery Viable Choice for Mandible Reconstruction
  • Vascularized Flaps Useful in Reducing PCF
  • Endoscopic Skull Base Surgery Indications Continue to Expand
  • Stereotactic Radiotherapy Treats Skull Base Tumors: Part 2 of

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Weaning Patients Off of PPIs
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.