Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap Reconstruction of Skull Base Defects
Advances in endoscopic skull base (SB) surgery have led to the resection of increasingly larger cranial base lesions, resulting in large SB defects. These defects have initially led to increased postoperative cerebrospinal fluid (CSF) leaks. The development of the vascularized pedicled nasoseptal fl...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2013-03-01
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| Series: | Allergy & Rhinology |
| Online Access: | https://doi.org/10.2500/ar.2013.4.0050 |
| _version_ | 1818059375878602752 |
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| author | Qasim Husain B.S. Saurin Sanghvi B.S. Olga Kovalerchik B.A. Pratik A. Shukla M.D. Osamah J. Choudhry M.D. James K. Liu M.D. Jean Anderson Eloy M.D., F.A.C.S. |
| author_facet | Qasim Husain B.S. Saurin Sanghvi B.S. Olga Kovalerchik B.A. Pratik A. Shukla M.D. Osamah J. Choudhry M.D. James K. Liu M.D. Jean Anderson Eloy M.D., F.A.C.S. |
| author_sort | Qasim Husain B.S. |
| collection | DOAJ |
| description | Advances in endoscopic skull base (SB) surgery have led to the resection of increasingly larger cranial base lesions, resulting in large SB defects. These defects have initially led to increased postoperative cerebrospinal fluid (CSF) leaks. The development of the vascularized pedicled nasoseptal flap (PNSF) has successfully reduced postoperative CSF leaks. Mucocele formation, however, has been reported as a complication of this technique. In this study, we analyze the incidence of mucocele formation after repair of SB defects using a PNSF. A retrospective review was performed from December 2008 to December 2011 to identify patients who underwent PNSF reconstruction for large ventral SB defects. Demographic data, defect site, incidence of postoperative CSF leaks, and rate of mucocele formation were collected. Seventy patients undergoing PNSF repair of SB defects were identified. No postoperative mucocele formation was noted at an average radiological follow-up of 11.7 months (range, 3–36.9 months) and clinical follow-up of 13.8 months (range, 3–38.9 months), making the overall mucocele rate 0%. The postoperative CSF leak rate was 2.9%. Proper closure of SB defects is crucial to prevent CSF leaks. The PNSF is an efficient technique for these repairs. Although this flap may carry an inherent risk of mucocele formation when placed over mucosalized bone during repair, we found that meticulous and strategic removal of mucosa from the site of flap placement resulted in a 0% incidence of postoperative mucocele formation in our cohort. |
| first_indexed | 2024-12-10T13:15:32Z |
| format | Article |
| id | doaj.art-416cc7799f524581a72210e472bcf113 |
| institution | Directory Open Access Journal |
| issn | 2152-6567 |
| language | English |
| last_indexed | 2024-12-10T13:15:32Z |
| publishDate | 2013-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Allergy & Rhinology |
| spelling | doaj.art-416cc7799f524581a72210e472bcf1132022-12-22T01:47:32ZengSAGE PublishingAllergy & Rhinology2152-65672013-03-01410.2500/ar.2013.4.0050Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap Reconstruction of Skull Base DefectsQasim Husain B.S.0Saurin Sanghvi B.S.1Olga Kovalerchik B.A.2Pratik A. Shukla M.D.3Osamah J. Choudhry M.D.4James K. Liu M.D.5Jean Anderson Eloy M.D., F.A.C.S.6Departments of Otolaryngology– Head and Neck SurgeryDepartments of Otolaryngology– Head and Neck SurgeryDepartments of Otolaryngology– Head and Neck SurgeryDepartments of Otolaryngology– Head and Neck SurgeryDepartments of Neurological Surgery, Newark, New JerseyDepartments of Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New JerseyDepartments of Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, Newark, New JerseyAdvances in endoscopic skull base (SB) surgery have led to the resection of increasingly larger cranial base lesions, resulting in large SB defects. These defects have initially led to increased postoperative cerebrospinal fluid (CSF) leaks. The development of the vascularized pedicled nasoseptal flap (PNSF) has successfully reduced postoperative CSF leaks. Mucocele formation, however, has been reported as a complication of this technique. In this study, we analyze the incidence of mucocele formation after repair of SB defects using a PNSF. A retrospective review was performed from December 2008 to December 2011 to identify patients who underwent PNSF reconstruction for large ventral SB defects. Demographic data, defect site, incidence of postoperative CSF leaks, and rate of mucocele formation were collected. Seventy patients undergoing PNSF repair of SB defects were identified. No postoperative mucocele formation was noted at an average radiological follow-up of 11.7 months (range, 3–36.9 months) and clinical follow-up of 13.8 months (range, 3–38.9 months), making the overall mucocele rate 0%. The postoperative CSF leak rate was 2.9%. Proper closure of SB defects is crucial to prevent CSF leaks. The PNSF is an efficient technique for these repairs. Although this flap may carry an inherent risk of mucocele formation when placed over mucosalized bone during repair, we found that meticulous and strategic removal of mucosa from the site of flap placement resulted in a 0% incidence of postoperative mucocele formation in our cohort.https://doi.org/10.2500/ar.2013.4.0050 |
| spellingShingle | Qasim Husain B.S. Saurin Sanghvi B.S. Olga Kovalerchik B.A. Pratik A. Shukla M.D. Osamah J. Choudhry M.D. James K. Liu M.D. Jean Anderson Eloy M.D., F.A.C.S. Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap Reconstruction of Skull Base Defects Allergy & Rhinology |
| title | Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap
Reconstruction of Skull Base Defects |
| title_full | Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap
Reconstruction of Skull Base Defects |
| title_fullStr | Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap
Reconstruction of Skull Base Defects |
| title_full_unstemmed | Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap
Reconstruction of Skull Base Defects |
| title_short | Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap
Reconstruction of Skull Base Defects |
| title_sort | assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects |
| url | https://doi.org/10.2500/ar.2013.4.0050 |
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