비중격 피판 두개저 재건술 실패 후 하비갑개 피판 및 중비갑개 피판을 사용한 두개저 재건술 1예
Revision Skull Base Reconstruction Using Combined Inferior and Middle Turbinate Flap After Nasoseptal Flap Failure
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When patients with a history of skull base reconstruction where nasoseptal flap was used requirerevision surgery, selecting an appropriate flap may be challenging. We report here a successfulexperience of using combined inferior and middle turbinate flap for revision skull base recon-struction after a nasoseptal flap failure at 22 days postoperatively. A 63-year-old female com-plaining of right vision loss was referred for co-operation. The patient had undergone transsphe-noidal approach (TSA) resection for a pituitary adenoma 20 years ago. Sella turcica MRI showeda recurrent pituitary adenoma of 3.5×5.3-cm in size in the sellar and suprasellar areas, extendingto the right cavernous sinus. Endoscopic extended TSA with nasoseptal flap reconstruction wasperformed for the patient. Flap necrosis followed and flap failure progressed after 10 postopera-tive days. The patient then underwent a skull base reconstruction using a vascularized inferiorturbinate flap and a contralateral middle turbinate flap. Postoperatively, the revision flaps suc-cessfully covered the skull base defect without complications.
Abstract
When patients with a history of skull base reconstruction where nasoseptal flap was used requirerevision surgery, selecting an appropriate flap may be challenging. We report here a successfulexperience of using combined inferior and middle turbinate flap for revision skull base recon-struction after a nasoseptal flap failure at 22 days postoperatively. A 63-year-old female com-plaining of right vision loss was referred for co-operation. The patient had undergone transsphe-noidal approach (TSA) resection for a pituitary adenoma 20 years ago. Sella turcica MRI showeda recurrent pituitary adenoma of 3.5×5.3-cm in size in the sellar and suprasellar areas, extendingto the right cavernous sinus. Endoscopic extended TSA with nasoseptal flap reconstruction wasperformed for the patient. Flap necrosis followed and flap failure progressed after 10 postopera-tive days. The patient then underwent a skull base reconstruction using a vascularized inferiorturbinate flap and a contralateral middle turbinate flap. Postoperatively, the revision flaps suc-cessfully covered the skull base defect without complications.
참고문헌 (11)
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