Cadaveric study for skull base reconstruction using anteriorly based inferior turbinate flap

Area of Science:

• Otolaryngology
• Neurosurgery
• Skull Base Surgery

Background:

• Endoscopic techniques are increasingly used for anterior skull base reconstruction.
• Nasal septal flaps are common but not always available.
• Alternative vascularized flaps are needed for complex reconstructions.

Purpose of the Study:

• To assess the feasibility of using an anteriorly pedicled inferior turbinate flap (AITF) for endoscopic anterior skull base reconstruction.
• To evaluate the AITF's coverage and efficacy in the absence of a nasal septal flap.

Main Methods:

• A cadaveric feasibility study was conducted to determine flap dimensions and coverage.
• The AITF was then used in ten patients to reconstruct anterior skull base defects.
• Flap harvesting, size, extent of coverage, and patient outcomes were analyzed.

Main Results:

• Cadaveric analysis showed AITFs provided significant coverage (mean 111%) of the anterior skull base.
• In ten patients, AITF reconstruction was successful.
• No postoperative cerebrospinal fluid (CSF) leaks or meningitis occurred in the patient cohort.

Conclusions:

• The anteriorly pedicled inferior turbinate flap (AITF) is a viable and effective option for endoscopic anterior skull base reconstruction.
• AITF offers a valuable alternative when nasal septal flaps are not suitable or available.
• This technique demonstrates safety and efficacy in preventing postoperative CSF leaks and meningitis.