How we do it: mini posterior septal artery flap for coverage after transphenoidal approaches

Area of Science:

• Otorhinolaryngology
• Neurosurgery
• Endoscopic Skull Base Surgery

Background:

• Endoscopic endonasal surgery is increasingly used for sella and parasellar region access.
• Resection of the sphenoid face and posterior nasal septectomy are key steps in these procedures.
• Optimal mucosal preservation is crucial for postoperative healing and flap viability.

Purpose of the Study:

• To introduce a novel posterior nasal flap technique for endoscopic approaches to the sella and parasellar region.
• To describe the technique's reliance on preserving the angiosome of the posterior septal artery.
• To highlight the flap's benefits for mucosal preservation and potential for future reconstruction.

Main Methods:

• A novel posterior nasal flap is elevated from the mucosa of the posterior septum and sphenoid face.
• The angiosome supplied by the posterior septal artery is carefully preserved during flap elevation.
• The technique is designed for endoscopic resection of the sphenoid face and posterior nasal septectomy.

Main Results:

• Maximal mucosal preservation is achieved with this flap technique.
• The flap facilitates optimized postoperative healing.
• The technique has been demonstrated to allow for future elevation of a complete naso-septal flap for reconstruction.

Conclusions:

• The proposed posterior nasal flap is a valuable technique for endoscopic surgery of the sella and parasellar region.
• This method enhances mucosal preservation, promoting better healing.
• The flap offers reconstructive potential for anterior skull base defects.