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Complications associated with the pedicled nasoseptal flap for skull base reconstruction
Author(s) -
Soudry Ethan,
Psaltis Alkis J.,
Lee Kun H.,
Vaezafshar Reza,
Nayak Jayakar V.,
Hwang Peter H.
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24863
Subject(s) - skull , base (topology) , medicine , surgery , anatomy , mathematics , mathematical analysis
Objectives/Hypothesis To analyze complications associated with nasoseptal flap elevation and reconstruction in endoscopic skull base surgery. Study Design Case series. Methods Retrospective chart review of all patients who underwent nasoseptal flap procedure in our institution between 2008 and 2013. Results A total of 121 patients were identified with a mean follow‐up time of 10.4 months. Complications associated with this procedure occurred in 33 patients (27%). The majority of complications were related to the septal donor site and included septal perforation, cartilage necrosis, and prolonged crusting. Other complications included intraoperative injury to the flap pedicle (n = 4) or recurrent/persistent cerebrospinal fluid leak occurring in the early postoperative period (n = 7). Long‐term quality‐of‐life data assessed via Sinonasal Outcome Test‐22 questionnaires did not reveal notable differences when compared to preoperative scores. Conclusion The complication rate associated with nasoseptal flap elevation and inset is higher than previously described. The majority of complications became manifest beyond the immediate postoperative period and were associated with the septal donor site, including septal perforation, prolonged crusting, and cartilage necrosis. We hypothesize that donor site morbidity may be related to compromise of the contralateral septal vascular supply during the procedure. The range and frequency of complications of nasal septal flap surgery should be considered in counseling patients who may receive a nasoseptal flap for skull base reconstruction. Level of Evidence 4. Laryngoscope , 125:80–85, 2015