Assessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction
Abstract Background There have been several reconstructive methods with free flaps or vascular pedicled flaps constituting a large portion of the rebuilding of the skull base. The vascularized pedicled nasoseptal flap, however, appears to be the “gold standard” flap in the restoration of the integri...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-10-01
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| Series: | The Egyptian Journal of Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43163-023-00515-y |
| _version_ | 1827266742871654400 |
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| author | Anwar Abdelatty Ibrahim Hazem Negm Ahmad M. Hamdan |
| author_facet | Anwar Abdelatty Ibrahim Hazem Negm Ahmad M. Hamdan |
| author_sort | Anwar Abdelatty Ibrahim |
| collection | DOAJ |
| description | Abstract Background There have been several reconstructive methods with free flaps or vascular pedicled flaps constituting a large portion of the rebuilding of the skull base. The vascularized pedicled nasoseptal flap, however, appears to be the “gold standard” flap in the restoration of the integrity of the cranial base among all of the foregoing alternatives. This study aimed to assess the postoperative outcomes of endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction in 21 patients. Patients were assessed at 1 week postoperative using Sinonasal Outcome Test 22 (SNOT 22) to assess postoperative nasal symptoms. An endoscopic assessment of the nose was done at 1 week postoperative to assess the degree of crusting and at 4 weeks postoperative to assess the degree of nasal adhesions and the presence or absence of gangrene of the nasoseptal flap. Postoperative complications were assessed. Results The study patients included 12 cases with pituitary macroadenoma, five cases with anterior cranial fossa meningioma, and four cases with petroclival chordoma. The skull base defect size ranged from 2.5 to 4.5 cm. The most troublesome postoperative symptoms were decreased sense of smell/taste. Postoperatively, 10 patients had mild, 7 patients had moderate, and 4 patients had severe nasal crusting. Three cases had epistaxis and two cases had postoperative cerebrospinal fluid rhinorrhea. Ten cases had no nasal adhesions, four cases had mild, four cases had moderate, and three cases had severe nasal adhesions. No cases had gangrene of the nasoseptal flap. Conclusion The nasoseptal flap is an effective option for large skull base defect reconstruction after endoscopic resection of large skull base tumors with an acceptable postoperative patient quality of life and a low incidence of postoperative complications. |
| first_indexed | 2024-03-09T15:31:59Z |
| format | Article |
| id | doaj.art-3fcc0fdc7c1240669ce5070feff1e87e |
| institution | Directory Open Access Journal |
| issn | 2090-8539 |
| language | English |
| last_indexed | 2025-03-22T04:22:41Z |
| publishDate | 2023-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Otolaryngology |
| spelling | doaj.art-3fcc0fdc7c1240669ce5070feff1e87e2024-04-28T07:16:10ZengSpringerOpenThe Egyptian Journal of Otolaryngology2090-85392023-10-013911810.1186/s43163-023-00515-yAssessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstructionAnwar Abdelatty Ibrahim0Hazem Negm1Ahmad M. Hamdan2Otolaryngology Head & Neck Surgery Department, Faculty of Medicine, Menoufia UniversityNeurosurgery Department, Faculty of Medicine, Menoufia UniversityOtolaryngology Head & Neck Surgery Department, Faculty of Medicine, Menoufia UniversityAbstract Background There have been several reconstructive methods with free flaps or vascular pedicled flaps constituting a large portion of the rebuilding of the skull base. The vascularized pedicled nasoseptal flap, however, appears to be the “gold standard” flap in the restoration of the integrity of the cranial base among all of the foregoing alternatives. This study aimed to assess the postoperative outcomes of endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction in 21 patients. Patients were assessed at 1 week postoperative using Sinonasal Outcome Test 22 (SNOT 22) to assess postoperative nasal symptoms. An endoscopic assessment of the nose was done at 1 week postoperative to assess the degree of crusting and at 4 weeks postoperative to assess the degree of nasal adhesions and the presence or absence of gangrene of the nasoseptal flap. Postoperative complications were assessed. Results The study patients included 12 cases with pituitary macroadenoma, five cases with anterior cranial fossa meningioma, and four cases with petroclival chordoma. The skull base defect size ranged from 2.5 to 4.5 cm. The most troublesome postoperative symptoms were decreased sense of smell/taste. Postoperatively, 10 patients had mild, 7 patients had moderate, and 4 patients had severe nasal crusting. Three cases had epistaxis and two cases had postoperative cerebrospinal fluid rhinorrhea. Ten cases had no nasal adhesions, four cases had mild, four cases had moderate, and three cases had severe nasal adhesions. No cases had gangrene of the nasoseptal flap. Conclusion The nasoseptal flap is an effective option for large skull base defect reconstruction after endoscopic resection of large skull base tumors with an acceptable postoperative patient quality of life and a low incidence of postoperative complications.https://doi.org/10.1186/s43163-023-00515-yNasal outcomesNasoseptal flapMidline skull base tumorsSkull base reconstructionHadad-Bassagaisteguy flap |
| spellingShingle | Anwar Abdelatty Ibrahim Hazem Negm Ahmad M. Hamdan Assessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction The Egyptian Journal of Otolaryngology Nasal outcomes Nasoseptal flap Midline skull base tumors Skull base reconstruction Hadad-Bassagaisteguy flap |
| title | Assessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction |
| title_full | Assessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction |
| title_fullStr | Assessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction |
| title_full_unstemmed | Assessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction |
| title_short | Assessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction |
| title_sort | assessment of nasal outcomes after endoscopic removal of large midline skull base tumors with nasoseptal flap reconstruction |
| topic | Nasal outcomes Nasoseptal flap Midline skull base tumors Skull base reconstruction Hadad-Bassagaisteguy flap |
| url | https://doi.org/10.1186/s43163-023-00515-y |
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