Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objective: The authors evaluated the intermediate-term outcomes of a skull base reconstruction technique using hydroxyapatite cranioplasty combined with a nasoseptal flap following endoscopic endonasal surgery (EES) for suprasellar tumors. Specifically, the evaluation focused on the avoidance of lumbar CSF drainage, prevention of CSF leakage, and incidence of postoperative complications, including meningitis and nasoseptal flap necrosis, during a minimum follow-up of 2 years.
Methods: This multicenter study included patients who met the following criteria: 1) underwent EES for tuberculum sellae meningiomas or craniopharyngiomas, 2) received dual application of hydroxyapatite cranioplasty and reconstruction using a nasoseptal flap, 3) had a follow-up duration of at least 2 years, and 4) did not undergo lumbar drainage of CSF postoperatively. The success rate of reconstruction was determined based on postoperative CSF leakage, associated complications, meningitis, postoperative hospital length of stay (LOS), and would dehiscence.
Results: A total of 198 patients from three institutions diagnosed with tuberculum sellae meningioma (86 patients) or craniopharyngioma (112 patients) were included in this study. The median follow-up duration was 39 months. No patient underwent postoperative lumbar drainage of CSF. Postoperatively, only 3 patients (1.5%) experienced CSF leaks requiring reoperation. The median hospital LOS after surgery was 5 days. Other postoperative complications included atypical meningitis in 5 patients and wound dehiscence in 3 patients during the follow-up period. All patients with nonbacterial meningitis were treated with intravenous antibiotics and dexamethasone medication for 2 weeks.
Conclusions: The combination of hydroxyapatite cranioplasty and a nasoseptal flap in reconstruction following EES decreased the requirement for postoperative lumbar CSF drainage and shortened hospital LOSs with minimal morbidities. Nevertheless, careful attention to the risks of meningitis and central necrosis of a nasoseptal flap is crucial for optimizing patient outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.3171/2024.11.FOCUS24624 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Retrospective study on endonasal endoscopic management of cerebrospinal fluid rhinorrhea using pedicled nasal mucosal flap.
Eur Arch Otorhinolaryngol
August 2025
Department of Otorhinolaryngology Head and Neck Surgery, The first affiliated hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
Objectives: The goal of this study was to analyze the surgical efficacy and application value of using autologous materials (pedicled nasal mucosal flaps) as the main repair material for cerebrospinal fluid rhinorrhea under nasal endoscopy in our department in the past 5 years.
Methods: A retrospective analysis was conducted on patients who underwent cerebrospinal fluid rhinorrhea repair at our department between 1st February 2019 to 28th February 2024. Preoperative nasal endoscopy, computed tomography (CT) and/or magnetic resonance imaging (MRI) was performed to determine the location of the leak.
Airtight compartmentalization of the anterior skull base reconstructed using a pedicled pericranial periosteal flap: illustrative case.
J Neurosurg Case Lessons
August 2025
Departments of Neurosurgery, Tenri Hospital, Tenri, Nara Prefecture, Japan.
Background: Anterior skull base surgery to address tumor, trauma, or infection causing extensive bony destruction is associated with rhinorrhea and infection as potentially life-threatening complications. When performing anterior skull base reconstruction, watertight dural closure and airtight closure of the nasal cavity mucosa are essential for preventing these complications.
Observations: The authors describe the case of a patient with a mixed olfactory neuroblastoma and adenocarcinoma who underwent resection.
Collagen Matrix Combined With Hydroxyapatite and Nasoseptal Flap for Skull Base Reconstruction.
Laryngoscope Investig Otolaryngol
August 2025
Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea.
Background: Extended endoscopic endonasal transsphenoidal approaches (ExEETSA) commonly result in high-flow cerebrospinal fluid (CSF) leaks that demand robust reconstruction strategies. Although nasoseptal flap (NSF) is a standard reconstructive technique, high-flow grade 3 CSF leaks require additional rigid reconstruction. This study evaluated the long-term outcomes of collagen matrix-hydroxyapatite (HXA)-NSF for rigid skull base reconstruction without lumbar drain.
View Article and Find Full Text PDFThe use of fascia lata can minimize olfactory damage in endoscopic endonasal skull base surgery.
Rhinology
August 2025
Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi’an, China.
Objective: The purpose of this study was to compare the impact of using fascia lata versus a nasoseptal flap for skull base repair on olfactory function following endoscopic endonasal skull base surgery.
Methods: Patients who underwent the endoscopic endonasal transsphenoidal approach (EETA) or the extended endoscopic endonasal transsphenoidal approach (EEETA) were included in this study. The study included 80 patients who underwent skull base defect repair using fascia lata, while the control group consisted of 160 patients who underwent skull base defect repair using a nasoseptal flap.