ANZ journal of surgery · 2025
Outcomes After Pericranial Flap Reconstruction of the Anterior Skull Base After Transcribriform Resection of Sinonasal Tumors: A Retrospective Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Ramagiri Balaram, Hasan Zubair, Bekkers Stijn, Barnett Catherine, Bowman James, Amato Damian, Panizza Benedict
Аннотация
BACKGROUND: The nasoseptal flap is commonly used in the reconstruction of the anterior skull base following sinonasal tumor resection, but has limitations in its use.
METHODS: A retrospective case series at a quaternary referral center involved 13 consecutive anterior skull base resections reconstructed with a pericranial flap. Data collection included patient demographics, type of resection (endoscopic/open/combined), length of stay, follow-up and complications. The primary outcome was the cerebrospinal fluid (CSF) leakage rate and the secondary outcome was the overall complication rate.
RESULTS: The median age was 64 years (range: 32-75 years), and median follow-up was 24.8 months. Four patients (30.8%) had prior radiotherapy, and 10 patients (76.9%) had adjuvant radiotherapy. Eight patients (61.5%) underwent pure endoscopic resection, while the remaining five (38.5%) had a combined endoscopic resection with an open approach required for an orbital exenteration. None of the patients had an open craniotomy. Post-operative CSF leakage was 7.7% (n = 1) and the overall complication rate was 23.1% (n = 3). In addition to the CSF leak, one patient (7.7%) experienced a tension pneumocephalus and another (7.7%) had a delayed presentation of an ascending intracranial infection.
CONCLUSIONS: The pericranial flap is a useful extranasal pedicled flap for reconstruction of the anterior skull base when the nasoseptal flap is not available or inadequate. Complications such as CSF leakage, tension pneumocephalus and ascending intracranial infections are uncommon, though they can be adequately managed when present.
METHODS: A retrospective case series at a quaternary referral center involved 13 consecutive anterior skull base resections reconstructed with a pericranial flap. Data collection included patient demographics, type of resection (endoscopic/open/combined), length of stay, follow-up and complications. The primary outcome was the cerebrospinal fluid (CSF) leakage rate and the secondary outcome was the overall complication rate.
RESULTS: The median age was 64 years (range: 32-75 years), and median follow-up was 24.8 months. Four patients (30.8%) had prior radiotherapy, and 10 patients (76.9%) had adjuvant radiotherapy. Eight patients (61.5%) underwent pure endoscopic resection, while the remaining five (38.5%) had a combined endoscopic resection with an open approach required for an orbital exenteration. None of the patients had an open craniotomy. Post-operative CSF leakage was 7.7% (n = 1) and the overall complication rate was 23.1% (n = 3). In addition to the CSF leak, one patient (7.7%) experienced a tension pneumocephalus and another (7.7%) had a delayed presentation of an ascending intracranial infection.
CONCLUSIONS: The pericranial flap is a useful extranasal pedicled flap for reconstruction of the anterior skull base when the nasoseptal flap is not available or inadequate. Complications such as CSF leakage, tension pneumocephalus and ascending intracranial infections are uncommon, though they can be adequately managed when present.