• The Laryngoscope · Jun 2009

    Endoscopic pedicled nasoseptal flap reconstruction for pediatric skull base defects.

    • Rupali N Shah, Joshua B Surowitz, Mihir R Patel, Benjamin Y Huang, Carl H Snyderman, Ricardo L Carrau, Amin B Kassam, Anand V Germanwala, and Adam M Zanation.
    • Department of Otolaryngology-Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina 27599, USA.
    • Laryngoscope. 2009 Jun 1;119(6):1067-75.

    Objectives/HypothesisA prospective study of endoscopic expanded endonasal approaches (EEA) with nasoseptal flap reconstructions revealed anecdotal evidence of less available relative septal length in pediatric patients. Our goal is to use radioanatomic analysis of computed tomography (CT) scans to determine limitations of the nasoseptal flap in pediatric skull base reconstruction and to describe clinical outcomes after using the nasoseptal flap in six pediatric patients.Study DesignSix pediatric patients who underwent EEA with nasoseptal flap reconstruction were prospectively analyzed for flap coverage and postoperative cerebrospinal fluid (CSF) leak. Fifty maxillofacial CTs of individuals <18 years of age and 10 adult images underwent radioanatomic analysis.MethodsMeasurements included potential nasoseptal flap dimensions and dimensions required to reconstruct an anterior skull base defect, a trans-sellar defect, and a transclival defect. Measurements were compared to determine if flap size would be sufficient to cover independent EEA defects within different age groups.ResultsTwo out of three patients <14 years of age had inadequate flap coverage; one had a postoperative CSF leak. Patients >14 years of age had adequate flap coverage. Average potential flap length is less than average anterior skull base length until age 9 years to 10 years, and less than average trans-sellar defect length until age 6 years to 7 years. Septal growth is most rapid between 10 years and 13 years.Conclusions: The pedicled nasoseptal flap may not be a viable option for EEA reconstruction in children <10 years of age. This flap is a reliable option in patients >14 years of age, as their septums are comparable to adults. Patients 10 years to 13 years of age require careful consideration of facial analysis and preoperative radioanatomic evaluation on an individual basis. Laryngoscope, 2009.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.