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Article: Repair of Anterior Skull Base Defect by Dual-Layer/Split-Frontal Pericranial Flap

TitleRepair of Anterior Skull Base Defect by Dual-Layer/Split-Frontal Pericranial Flap
Authors
KeywordsCerebrospinal fluid leakage
Endoscopic surgical procedure
Pedicled flap
Skull base
Issue Date2019
PublisherElsevier Inc. The Journal's web site is located at http://www.worldneurosurgery.org/
Citation
World Neurosurgery, 2019, v. 122, p. 59-62 How to Cite?
AbstractIntroduction: Normal skull base structures are destroyed either by the skull base pathology itself or during surgery that results in cerebrospinal fluid (CSF) leak. Skull base repair is usually performed transnasally by using a nasal septal flap. But when NSF is not available and failed repeated transnasal repair, a cranionasal repair with frontal pericranial flap (PF) can be attempted to achieve the highest successful chance. We performed a dual layer/split PF repair of a skull base defect using cranionasal approach and here we describe the technique. Case Description: A 74-year-old man suffered from CSF leak and ventriculitis after multiple transnasal surgeries for pituitary macroadenoma despite multiple repairs with intranasal vascularized flaps. We performed repair by cranionasal approach and using frontal PF. The frontal PF was divided into left and right halves. The left half went intradural, through the chiasmatic window to reach the sella and cover the tubercular and sellar defect from above. The right half went through the nasion into the nose to cover the defect from below. So the defect was covered by two vascularized flap from a single frontal PF. The repair was successful with no CSF leak and infection successfully treated by antibiotics. Conclusion: We introduced the cranionasal dual layer/split PF technique to repair anterior skull base and successfully stopped the CSF leak in a patient after multiple EEA surgeries. This technique should only be considered in specific difficult situation where usual repair by EEA is impossible.
Persistent Identifierhttp://hdl.handle.net/10722/266050
ISSN
2019 Impact Factor: 1.829
2015 SCImago Journal Rankings: 0.526
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, LF-
dc.contributor.authorPu, KSJ-
dc.contributor.authorChung, CKJ-
dc.contributor.authorLui, WM-
dc.contributor.authorLeung, GKK-
dc.date.accessioned2018-12-17T02:16:38Z-
dc.date.available2018-12-17T02:16:38Z-
dc.date.issued2019-
dc.identifier.citationWorld Neurosurgery, 2019, v. 122, p. 59-62-
dc.identifier.issn1878-8750-
dc.identifier.urihttp://hdl.handle.net/10722/266050-
dc.description.abstractIntroduction: Normal skull base structures are destroyed either by the skull base pathology itself or during surgery that results in cerebrospinal fluid (CSF) leak. Skull base repair is usually performed transnasally by using a nasal septal flap. But when NSF is not available and failed repeated transnasal repair, a cranionasal repair with frontal pericranial flap (PF) can be attempted to achieve the highest successful chance. We performed a dual layer/split PF repair of a skull base defect using cranionasal approach and here we describe the technique. Case Description: A 74-year-old man suffered from CSF leak and ventriculitis after multiple transnasal surgeries for pituitary macroadenoma despite multiple repairs with intranasal vascularized flaps. We performed repair by cranionasal approach and using frontal PF. The frontal PF was divided into left and right halves. The left half went intradural, through the chiasmatic window to reach the sella and cover the tubercular and sellar defect from above. The right half went through the nasion into the nose to cover the defect from below. So the defect was covered by two vascularized flap from a single frontal PF. The repair was successful with no CSF leak and infection successfully treated by antibiotics. Conclusion: We introduced the cranionasal dual layer/split PF technique to repair anterior skull base and successfully stopped the CSF leak in a patient after multiple EEA surgeries. This technique should only be considered in specific difficult situation where usual repair by EEA is impossible.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.worldneurosurgery.org/-
dc.relation.ispartofWorld Neurosurgery-
dc.subjectCerebrospinal fluid leakage-
dc.subjectEndoscopic surgical procedure-
dc.subjectPedicled flap-
dc.subjectSkull base-
dc.titleRepair of Anterior Skull Base Defect by Dual-Layer/Split-Frontal Pericranial Flap-
dc.typeArticle-
dc.identifier.emailLi, LF: lfrandom@hku.hk-
dc.identifier.emailChung, CKJ: chungj@hku.hk-
dc.identifier.emailLui, WM: mattlui@hku.hk-
dc.identifier.emailLeung, GKK: gkkleung@hku.hk-
dc.identifier.authorityLeung, GKK=rp00522-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.wneu.2018.10.112-
dc.identifier.scopuseid_2-s2.0-85056609690-
dc.identifier.hkuros296377-
dc.identifier.volume122-
dc.identifier.spage59-
dc.identifier.epage62-
dc.identifier.isiWOS:000457328100212-
dc.publisher.placeUnited States-

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