두개저 결손부위 재건 시 비중격 피판의 변연 장력 완화 방법

Abstract

The successful reconstruction of anterior skull base defects following transcribriform ortranssphenoidal surgery is pivotal in mitigating the communication between the external en-vironment and the cranial cavity. This intervention is crucial to prevent potential complica-tions, including cerebrospinal f luid leakage and meningitis. The ideal reconstructive f lapshould possess sufficient vascularity and be of ample size to adequately cover vital nerves andvessels. Predominantly, the nasoseptal flap is employed for the repair of skull base defects. This flap is vascularized by the posterior division of the sphenopalatine artery, ensuring suffi-cient coverage of the defects. A significant advantage of the nasoseptal flap is its rotational ca-pability, allowing for mobilization and repositioning to effectively cover the defect. Nonethe-less, the rotational tension on the nasoseptal flap running from the nasal cavity to the skullbase may affect the distal margin of the f lap. Alleviation of this tension can be achievedthrough the insertion of multiple minuscule incisions in the vertical axis of the flap’s border. This report introduces and elaborates on this technique.