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Vascular pedicled flaps for skull base defect reconstruction.

Wade R Gutierrez¹, Douglas M Bennion², Jarrett E Walsh²

¹Medical Scientist Training Program University of Iowa Carver College of Medicine Iowa City Iowa USA.

Laryngoscope Investigative Otolaryngology

|December 28, 2020

Summary

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The nasoseptal flap is the leading technique for skull base defect repair, offering high success rates. Ongoing research explores new vascular pedicled flap methods to improve surgical outcomes.

Area of Science:

Otolaryngology
Neurosurgery
Plastic Surgery

Background:

Skull base defect reconstruction has seen significant advancements since the nasoseptal flap's introduction in 2006.
Vascular pedicled flaps are crucial for repairing complex skull base defects.

Purpose of the Study:

To review current intranasal and extranasal vascular pedicled flap techniques for skull base defect repair.
To assess indications, success rates, and emerging techniques in the field.

Main Methods:

A comprehensive literature review was performed using PubMed and Google Scholar.
Studies focusing on vascular pedicled flaps for skull base reconstruction were analyzed.

Main Results:

The nasoseptal flap is the most frequently used flap for endoscopic skull base repair due to its ease of use and high success rates.

Keywords:

endoscopic surgery skull base reconstruction surgical outcomes surgical techniques vascular pedicled flaps

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Variations like the "rescue" nasoseptal flap and other intranasal flaps (middle turbinate, inferior turbinate) are utilized.

Extranasal flaps (pericranial, temporoparietal fascia) are less common but remain important for specific cases.

Conclusions:

The field of skull base defect reconstruction with vascular pedicled flaps is continually evolving.
While the nasoseptal flap is dominant, research into novel intranasal techniques aims to further optimize surgical results and patient care.