Management of anterior skull base defect depending on its size and location
| Autor: | Freddy Enrique Agredo-Lemos, Manuel Bernal-Sprekelsen, Karla Enriquez, Elena Rioja, Joaquim Enseñat, Isam Alobid, Liza Viscovich |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Article Subject medicine.medical_treatment lcsh:Medicine Osteotomy General Biochemistry Genetics and Molecular Biology Surgical Flaps Young Adult Fascia lata medicine Humans Aged Retrospective Studies Aged 80 and over Skull Base General Immunology and Microbiology medicine.diagnostic_test Cerebrospinal fluid leak Cerebrospinal Fluid Leak business.industry lcsh:R Endoscopy General Medicine Pedicled Flap Middle Aged Plastic Surgery Procedures medicine.disease eye diseases Surgery body regions Skull medicine.anatomical_structure Treatment Outcome Mucoperiosteum Female business Research Article |
| Zdroj: | BioMed Research International BioMed Research International, Vol 2014 (2014) |
| ISSN: | 2314-6141 |
| Popis: | Introduction. We present our experience in the reconstruction of these leaks depending on their size and location.Material and Methods. Fifty-four patients who underwent advanced skull base surgery (large defects,>20 mm) and 62 patients with CSF leaks of different origin (small, 2–10 mm, and midsize, 11–20 mm, defects) were included in the retrospective study. Large defects were reconstructed with a nasoseptal pedicled flap positioned on fat and fascia lata. In small and midsized leaks. Fascia lata in anunderlayposition was used for its reconstruction covered with mucoperiosteum of either the middle or the inferior turbinate.Results. The most frequent etiology for small and midsized defects was spontaneous (48.4%), followed by trauma (24.2%), iatrogenic (5%). The success rate after the first surgical reconstruction was 91% and 98% in large skull base defects and small/midsized, respectively. Rescue surgery achieved 100%.Conclusions. Endoscopic surgery for any type of skull base defect is the gold standard. The size of the defects does not seem to play a significant role in the success rate. Fascia lata and mucoperiosteum of the turbinate allow a two-layer reconstruction of small and midsized defects. For larger skull base defects, a combination of fat, fascia lata, and nasoseptal pedicled flaps provides a successful reconstruction. |
| Databáze: | OpenAIRE |
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