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재발성 뇌하수체 선종 수술 후 비중격피판을 이용한 두개저 재건 1예

A Case of Endonasal Endoscopic Skull Base Repair Using Nasoseptal Flap after Revision Transsphenoidal Surgery for Pituitary Adenoma

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참고문헌

키워드

주제분류이비인후과학

초록

Nasoseptal flap is the reliable reconstructive technique for skull base defect using nasal endoscope. It has been popular because of the hypervascularity as a pedicle flap, tolerable donor site morbidity and higher success rate than a free graft. Several studies shows the usefulness of nasoseptal flap although patients have the history of septal surgery including transsphenoidal pituitary surgery. This case report presents a 68 year old man with visu- al disturbance, which was diagnosed as recurrent pituitary adenoma and cured by transsphenoidal pituitary sur- gery with endoscopic endonasal skull base repair with nasoseptal flap. The authors introduce the case and review the consideration in performing nasoseptal flap for patients with the history of septal surgery.

Abstract

Nasoseptal flap is the reliable reconstructive technique for skull base defect using nasal endoscope. It has been popular because of the hypervascularity as a pedicle flap, tolerable donor site morbidity and higher success rate than a free graft. Several studies shows the usefulness of nasoseptal flap although patients have the history of septal surgery including transsphenoidal pituitary surgery. This case report presents a 68 year old man with visu- al disturbance, which was diagnosed as recurrent pituitary adenoma and cured by transsphenoidal pituitary sur- gery with endoscopic endonasal skull base repair with nasoseptal flap. The authors introduce the case and review the consideration in performing nasoseptal flap for patients with the history of septal surgery.

참고문헌 (13)

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  3. Krings JG, "Complications following primary and revision transsphenoidal surgeries for pituitary tumors", Laryngoscope, 125(2), pp.311~317 (2015)
  4. Heringer LC, "Effect of repeated transsphenoidal surgery in recurrent or residual pituitary adenomas:aA systematic review and metaanalysis", Surg Neurol Int, 7, pp.14~ (2016)
  5. 이건희, "비중격피판을 이용한 두개저 재건", 대한이비인후-두경부외과학회지, 58(1), pp.7~11 (2015), 대한이비인후과학회[DOI]
  6. Kassam AB, "Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap", Neurosurgery, 63(1 Suppl), pp.44~53 (2008)
  7. 정유삼, "편측 비공을 통한 비강내 경접형동접근법을 이용한 뇌하수체 종양 수술", 대한이비인후-두경부외과학회지, 50(7), pp.590~595 (2007), 대한이비인후과학회
  8. Hadad G, "A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap", Laryngoscope, 116(10), pp.1882~1886 (2006)
  9. Gondim JA, "Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients", Pituitary, 14(2), pp.174~183 (2011)
  10. Remi A. Kessler, "Utilization of the nasoseptal flap for repair of cerebrospinal fluid leak after endoscopic endonasal approach (EEA) for resection of pituitary tumors", Brain Tumor Research and Treatment, 7(1), pp.10~15 (2019), 대한뇌종양학회[DOI]
  11. Park W, "Nasoseptal flap elevation in patients with history of septal surgery: does it increase flap failure or cerebrospinal fluid leakage", World Neurosurg, 93, pp.164~167 (2016)
  12. El-Sayed IH, "Endoscopic reconstruction of skull base defects with the nasal septal flap", Skull Base, 18(6), pp.385~394 (2008)
  13. Huntley C, "Perforation of a nasoseptal flap does not increase the rate of postoperative cerebrospinal fluid leak", Int Forum Allergy Rhinol, 5(4), pp.353~355 (2015)

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