Mucocele rate after endoscopic skull base reconstruction using vascularized pedicled flaps
Mucocele rate after endoscopic skull base reconstruction using vascularized pedicled flaps
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DOI：
10.2500/ajra.2011.25.3587
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发表时间：
2011-05-01
影响因子：
2.6
通讯作者：
Schlosser, Rodney J.
中科院分区：
文献类型：
--
作者：
Bleier, Benjamin S.;Wang, Eric W.;Schlosser, Rodney J.
背景：术后脑脊液漏是内窥镜颅底手术后的一个重大风险。最近，新的重建技术，使用血管蒂粘膜瓣已被应用，以减少这种潜在的风险。在创面完全切除粘膜并不总是可行的，在完整的底层粘膜上插入皮瓣的影响也不清楚。本研究的目的是确定鼻中隔皮瓣重建后的粘液囊肿形成率，粘膜stripping.Methods：这是一个机构审查委员会批准的，回顾性研究，包括28例患者进行颅底重建，使用带蒂鼻中隔皮瓣之间的2008年和2010年在三级医院。在所有病例中，缺损周围的窦或颅底粘膜均保持完整。术后随访患者内镜检查和/或影像学检查的证据粘液囊肿形成的重建bed.Results：粘液囊肿形成的总率为3.6%（1 28，注意到术后第46天）。平均随访时间为243 ± 174天（范围：46-585天）。11例患者随访1年以上。结论：带蒂鼻中隔瓣是鼻内窥镜下颅底手术后修复缺损的有效方法。避免周围粘膜的广泛剥离不会导致短期内术后粘液囊肿形成的显著发生率。仍需长期随访。(Am J Rhinol Allergy 25，186-187，2011; doi：10.2500/ajra.2011.25.3587）
Background: Postoperative cerebrospinal fluid leak is a significant risk after endoscopic skull base surgery. Recently, novel reconstructive techniques using vascularized pedicled mucosal flaps have been applied to decrease this potential risk. Complete mucosal extirpation in the wound bed is not always feasible and the impact of insetting the flap over intact underlying mucosa is not clear. The purpose of this study was to determine the rate of mucocele formation after nasoseptal flap reconstruction without mucosal stripping.Methods: This is an Institutional Review Board approved, retrospective study consisting of 28 patients undergoing skull base reconstruction using a pedicled nasoseptal flap between 2008 and 2010 at a tertiary care hospital. In all cases the sinus or skull base mucosa surrounding the defect was left intact. Patients were followed postoperatively by endoscopy and/or imaging for evidence of mucocele formation in the reconstructive bed.Results: The total rate of mucocele formation was 3.6% (1 of 28, noted on postoperative day 46). The mean follow-up time was 243 +/- 174 days (range, 46-585 days). Eleven patients were followed for over I year. All flaps remained viable and well vascularized.Conclusion: The pedicled nasoseptal flap is an effective means of reconstruction after endoscopic skull base surgery. Avoidance of extensive stripping of the surrounding mucosa does not result in a significant rate of postoperative mucocele formation in the short term. Long-term follow-up is still indicated. (Am J Rhinol Allergy 25, 186-187, 2011; doi: 10.2500/ajra.2011.25.3587)