Cadaveric study for skull base reconstruction using anteriorly based inferior turbinate flap. 2013

Moran Amit, and Jacob Cohen, and Ilan Koren, and Ziv Gil
Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Haifa, Israel.

OBJECTIVE To demonstrate the feasibility of an anteriorly pedicled inferior turbinate flap (AITF) as a method for endoscopic reconstruction of anterior skull base defects in the absence of a nasal septal flap. METHODS Cadaveric feasibility study. METHODS University-affiliated tertiary medical center. METHODS A cadaveric model was used to investigate the feasibility of harvesting and skull base reconstruction with an AITF. The size and extent of coverage of the flap were investigated. Subsequently, defects resulting from an endoscopic resection of various anterior skull base pathologies were reconstructed with an AITF in patients. RESULTS In the cadaveric model (n = 11), the mean length, width, and area of the AITFs were 4.76 ± 0.52 cm, 1.8 ± 0.34 cm, and 4.31 ± 0.87 cm(2), respectively. The flap provided a mean of 111 ± 12% (range 95%-133%) coverage of the anterior skull base from the posterior table of the frontal sinus to the sella. Following that experience, ten patients were successfully reconstructed with AITFs, and there were no postoperative cerebrospinal fluid (CSF) leaks or occurrence of meningitis. CONCLUSIONS The results of this study demonstrate the feasibility of AITFs for the reconstruction of anterior skull base defects in the absence of alternative vascularized flaps.

UI MeSH Term Description Entries
D008297 Male Males
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D002559 Cerebrospinal Fluid Rhinorrhea Discharge of cerebrospinal fluid through the nose. Common etiologies include trauma, neoplasms, and prior surgery, although the condition may occur spontaneously. (Otolaryngol Head Neck Surg 1997 Apr;116(4):442-9) Cerebrospinal Rhinorrhea,CSF Rhinorrhea,Cerebrospinal Fluid Rhinorrhea, Post-Traumatic,Cerebrospinal Fluid Rhinorrhea, Spontaneous,Cerebrospinal Fluid Rhinorrhea, Traumatic,Post-Traumatic Cerebrospinal Fluid Rhinorrhea,Post-Traumatic Rhinorrhea, Cerebrospinal Fluid,Rhinorrhea, Cerebrospinal Fluid, Post-Traumatic,Rhinorrhea, Cerebrospinal Fluid, Spontaneous,Rhinorrhea, Cerebrospinal Fluid, Traumatic,Rhinorrhea, Post-Traumatic, Cerebrospinal Fluid,Rhinorrhea, Spontaneous Cerebrospinal Fluid,Rhinorrhea, Traumatic Cerebrospinal Fluid,Spontaneous Cerebrospinal Fluid Rhinorrhea,Spontaneous Rhinorrhea, Cerebrospinal Fluid,Traumatic Cerebrospinal Fluid Rhinorrhea,Traumatic Rhinorrhea, Cerebrospinal Fluid,CSF Rhinorrheas,Cerebrospinal Fluid Rhinorrhea, Post Traumatic,Cerebrospinal Fluid Rhinorrheas,Cerebrospinal Rhinorrheas,Post Traumatic Cerebrospinal Fluid Rhinorrhea,Post Traumatic Rhinorrhea, Cerebrospinal Fluid,Rhinorrhea, CSF,Rhinorrhea, Cerebrospinal,Rhinorrhea, Cerebrospinal Fluid,Rhinorrheas, CSF,Rhinorrheas, Cerebrospinal,Rhinorrheas, Cerebrospinal Fluid
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D005240 Feasibility Studies Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project. Feasibility Study,Studies, Feasibility,Study, Feasibility
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013524 Surgical Flaps Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region. Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps
D014420 Turbinates The scroll-like bony plates with curved margins on the lateral wall of the NASAL CAVITY. Turbinates, also called nasal concha, increase the surface area of nasal cavity thus providing a mechanism for rapid warming and humidification of air as it passes to the lung. Nasal Concha,Conchae Nasales,Conchae Nasale,Nasal Conchas,Turbinate
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face

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