A New Technique for the Endoscopic Reconstruction of Skull Base Defects Using Multiple-balloon Catheters
Cerebrospinal fluid (CSF) leakage is a major complication following endoscopic endonasal skull base surgery. Various skull base reconstruction methods are available, and the use of a vascularized nasoseptal flap (NSF) in skull base reconstruction has greatly contributed to a decrease in the CSF leak...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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The Japan Neurosurgical Society
2022-10-01
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| Series: | Neurologia Medico-Chirurgica |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/nmc/62/10/62_2022-0146/_pdf/-char/en |
| _version_ | 1811246998920101888 |
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| author | Asuka FUJINO Yoji TANAKA Daisu ABE Yosuke ARIIZUMI Motoki INAJI Taketoshi MAEHARA |
| author_facet | Asuka FUJINO Yoji TANAKA Daisu ABE Yosuke ARIIZUMI Motoki INAJI Taketoshi MAEHARA |
| author_sort | Asuka FUJINO |
| collection | DOAJ |
| description | Cerebrospinal fluid (CSF) leakage is a major complication following endoscopic endonasal skull base surgery. Various skull base reconstruction methods are available, and the use of a vascularized nasoseptal flap (NSF) in skull base reconstruction has greatly contributed to a decrease in the CSF leak rate. A balloon catheter such as a sinus balloon or a Foley catheter is often used to support an NSF; however, in cases wherein nasal and/or paranasal structures supporting the balloon are lacking following the surgery, the NSF is not properly fixed and postoperative CSF leak may occur. Here we introduce a new technique of using multiple-balloon catheters to fix an NSF in such cases and provide the results of our analysis of the new technique's efficacy. Eight patients who underwent endonasal endoscopic surgery for the following cases were included: olfactory neuroblastoma (n = 6), recurrent craniofacial meningioma (n = 1), and recurrent chordoma (n = 1). After tumor resection, multilayered reconstruction with vascularized NSF was performed. Given that the Foley catheter was not stable to fix the flap in each case, we used an additional nasal catheter to support the Foley catheter. No complications such as postoperative CSF leak and necrosis of the vascularized flap were observed. These results suggest that the multiple-balloon catheter technique is a useful method for fixing the NSF to the skull base even when nasal cavity structures are missing due to surgical removal. |
| first_indexed | 2024-04-12T15:01:54Z |
| format | Article |
| id | doaj.art-1d5961926e38488b9c169c6daefb0378 |
| institution | Directory Open Access Journal |
| issn | 1349-8029 |
| language | English |
| last_indexed | 2024-04-12T15:01:54Z |
| publishDate | 2022-10-01 |
| publisher | The Japan Neurosurgical Society |
| record_format | Article |
| series | Neurologia Medico-Chirurgica |
| spelling | doaj.art-1d5961926e38488b9c169c6daefb03782022-12-22T03:28:03ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292022-10-01621048348710.2176/jns-nmc.2022-01462022-0146A New Technique for the Endoscopic Reconstruction of Skull Base Defects Using Multiple-balloon CathetersAsuka FUJINO0Yoji TANAKA1Daisu ABE2Yosuke ARIIZUMI3Motoki INAJI4Taketoshi MAEHARA5Department of Neurosurgery, Tokyo Medical and Dental UniversityDepartment of Neurosurgery, Tokyo Medical and Dental UniversityDepartment of Neurosurgery, Tokyo Medical and Dental UniversityDepartment of Head and Neck Surgery, Tokyo Medical and Dental UniversityDepartment of Neurosurgery, Tokyo Medical and Dental UniversityDepartment of Neurosurgery, Tokyo Medical and Dental UniversityCerebrospinal fluid (CSF) leakage is a major complication following endoscopic endonasal skull base surgery. Various skull base reconstruction methods are available, and the use of a vascularized nasoseptal flap (NSF) in skull base reconstruction has greatly contributed to a decrease in the CSF leak rate. A balloon catheter such as a sinus balloon or a Foley catheter is often used to support an NSF; however, in cases wherein nasal and/or paranasal structures supporting the balloon are lacking following the surgery, the NSF is not properly fixed and postoperative CSF leak may occur. Here we introduce a new technique of using multiple-balloon catheters to fix an NSF in such cases and provide the results of our analysis of the new technique's efficacy. Eight patients who underwent endonasal endoscopic surgery for the following cases were included: olfactory neuroblastoma (n = 6), recurrent craniofacial meningioma (n = 1), and recurrent chordoma (n = 1). After tumor resection, multilayered reconstruction with vascularized NSF was performed. Given that the Foley catheter was not stable to fix the flap in each case, we used an additional nasal catheter to support the Foley catheter. No complications such as postoperative CSF leak and necrosis of the vascularized flap were observed. These results suggest that the multiple-balloon catheter technique is a useful method for fixing the NSF to the skull base even when nasal cavity structures are missing due to surgical removal.https://www.jstage.jst.go.jp/article/nmc/62/10/62_2022-0146/_pdf/-char/enneuroendoscopyskull base reconstructionballoon cathetercerebrospinal fluid leak |
| spellingShingle | Asuka FUJINO Yoji TANAKA Daisu ABE Yosuke ARIIZUMI Motoki INAJI Taketoshi MAEHARA A New Technique for the Endoscopic Reconstruction of Skull Base Defects Using Multiple-balloon Catheters Neurologia Medico-Chirurgica neuroendoscopy skull base reconstruction balloon catheter cerebrospinal fluid leak |
| title | A New Technique for the Endoscopic Reconstruction of Skull Base Defects Using Multiple-balloon Catheters |
| title_full | A New Technique for the Endoscopic Reconstruction of Skull Base Defects Using Multiple-balloon Catheters |
| title_fullStr | A New Technique for the Endoscopic Reconstruction of Skull Base Defects Using Multiple-balloon Catheters |
| title_full_unstemmed | A New Technique for the Endoscopic Reconstruction of Skull Base Defects Using Multiple-balloon Catheters |
| title_short | A New Technique for the Endoscopic Reconstruction of Skull Base Defects Using Multiple-balloon Catheters |
| title_sort | new technique for the endoscopic reconstruction of skull base defects using multiple balloon catheters |
| topic | neuroendoscopy skull base reconstruction balloon catheter cerebrospinal fluid leak |
| url | https://www.jstage.jst.go.jp/article/nmc/62/10/62_2022-0146/_pdf/-char/en |
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