Evolution of Radiographic Changes of a Vascularized Pedicled Nasoseptal Flap after Endonasal Endoscopic Skull Base Surgery.

Autor:	Birkenbeuel JL; From the Departments of Otolaryngology-Head and Neck Surgery (J.L.B., A.A., T.N., B.F.B., E.F.A., M.V., E.C.K.)., Abiri A; From the Departments of Otolaryngology-Head and Neck Surgery (J.L.B., A.A., T.N., B.F.B., E.F.A., M.V., E.C.K.)., Nguyen T; From the Departments of Otolaryngology-Head and Neck Surgery (J.L.B., A.A., T.N., B.F.B., E.F.A., M.V., E.C.K.)., Bitner BF; From the Departments of Otolaryngology-Head and Neck Surgery (J.L.B., A.A., T.N., B.F.B., E.F.A., M.V., E.C.K.)., Abello EF; From the Departments of Otolaryngology-Head and Neck Surgery (J.L.B., A.A., T.N., B.F.B., E.F.A., M.V., E.C.K.)., Vasudev M; From the Departments of Otolaryngology-Head and Neck Surgery (J.L.B., A.A., T.N., B.F.B., E.F.A., M.V., E.C.K.)., Hsu FPK; Neurological Surgery (F.P.K.H., E.C.K.)., Kuoy E; Radiology (E.K.), Division of Neuroradiology, University of California, Irvine, Irvine, California., Kuan EC; From the Departments of Otolaryngology-Head and Neck Surgery (J.L.B., A.A., T.N., B.F.B., E.F.A., M.V., E.C.K.) eckuan@uci.edu.; Neurological Surgery (F.P.K.H., E.C.K.).
Jazyk:	angličtina
Zdroj:	AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 2023 Feb; Vol. 44 (2), pp. 171-175. Date of Electronic Publication: 2023 Jan 19.
DOI:	10.3174/ajnr.A7768
Abstrakt:	Background and Purpose: There is active research involving the radiographic appearance of the skull base following reconstruction. The purpose of this study was to describe the radiographic appearance of the vascularized pedicle nasoseptal flap after endoscopic skull base surgery across time. Materials and Methods: We performed chart and imaging review of all patients with intraoperative nasoseptal flap placement during endoscopic skull base surgery at a tertiary academic skull base surgery program between July 2018 and March 2021. All patients underwent immediate and delayed (>3 months) postoperative MR imaging. Primary outcome variables included flap and pedicle enhancement, flap thickness, and flap adherence to the skull base. Results: Sixty-eight patients were included. Flap ( P = .003) enhancement significantly increased with time. Mean nasoseptal flap thickness on immediate and delayed postoperative scans was 3.8 and 3.9 mm, respectively ( P = .181). The nasoseptal flap adhered entirely to the skull base in 37 (54.4%) and 67 (98.5%) patients on immediate and delayed imaging, respectively ( P  < .001). Conclusions: Our findings demonstrate heterogeneity of the nasoseptal flap appearance after skull base reconstruction. While it is important for surgeons and radiologists to evaluate variations in flap appearance, the absence of enhancement and lack of adherence to the skull base on immediate postoperative imaging do not appear to predict reconstructive success and healing, with many flaps "self-adjusting" with time. (© 2023 by American Journal of Neuroradiology.)
Databáze:	MEDLINE
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