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Sphenoid Sinus Mucosal Flap after Transsphenoidal Surgery-A Systematic Review
Piotr Sumislawski1, Martyna Piotrowska2, Jan Regelsberger3
1Department of Neurosurgery, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.
Medicina (Kaunas, Lithuania)
|February 24, 2024
Summary
The sphenoid mucosal flap (SMF) technique effectively reconstructs the skull base after transsphenoidal surgery. It reduces cerebrospinal fluid leaks and local complications, improving sinonasal quality of life.
Area of Science:
- Neurosurgery
- Otolaryngology
Background:
- Skull base reconstruction is vital post-transsphenoidal surgery.
- Sphenoid mucosa preservation as a flap may aid closure.
Approach:
- Systematic review of 10 studies (1671 patients) from January 2023.
- Searched Cochrane, EMBASE, PubMed, Scopus, and Web of Science.
Key Points:
- Total sphenoid mucosal flap (SMF) covering reduced CSF leaks (p=0.008) and lumbar drain duration (p=0.003).
- SMF use decreased local complications like graft necrosis and sinusitis (p=0.012).
- Three flap types exist: intersinus septal, superiorly based, and inferiorly based.
Conclusions:
- SMF is effective for skull base reconstruction, minimizing avascular grafts and complications.
- This technique may enhance sinonasal quality of life via improved wound healing.
- Further studies are needed for higher-grade CSF leaks and combined techniques.
