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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
566
Nasoseptal Flap Reuse for Reconstruction in Revision Endoscopic Skull Base Surgery
Kevin T Grafmiller1, Nikitha Kosaraju2, Jessa E Miller1
1Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California, United States.
Journal of Neurological Surgery. Part B, Skull Base
|October 27, 2025
Summary
The nasoseptal flap (NSF) can be successfully reused for reconstruction in revision endoscopic skull base surgery, even up to 12 years after its initial use. This demonstrates its durability and effectiveness in preventing cerebrospinal fluid leaks.
Area of Science:
- Neurosurgery
- Otolaryngology
- Skull Base Surgery
Background:
- The nasoseptal flap (NSF) is crucial for reconstruction in endoscopic skull base surgery, providing watertight closure and preventing cerebrospinal fluid (CSF) leaks.
- Its vascular pedicle allows for potential reuse in subsequent surgeries, with prior studies showing success up to 24 months post-initial surgery.
Purpose of the Study:
- To analyze the outcomes of nasoseptal flaps (NSFs) reused in revision endoscopic skull base surgery.
- To evaluate the feasibility and safety of reusing NSFs even after extended periods (up to 12 years) following the initial surgery.
Main Methods:
- Retrospective analysis of patients undergoing revision endoscopic skull base surgery.
- Evaluation of patient demographics, tumor types, time intervals between surgeries, and surgical outcomes.
- Identification of 15 patients with reused NSFs between 2012 and 2022.
Main Results:
- Fifteen patients with reused NSFs were identified, with time intervals ranging from 9 months to 12 years.
- The majority of cases involved pituitary adenomas (12), with 2 Rathke's cleft cysts and 1 craniopharyngioma.
- One patient experienced a postoperative CSF leak, successfully managed with additional reconstructive techniques.
Conclusions:
- The nasoseptal flap (NSF) is a viable option for reconstruction in revision endoscopic skull base surgery.
- Reused NSFs provide excellent defect coverage with a low incidence of postoperative CSF leaks, even when reused years after the initial procedure.
