Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects

Advances in endoscopic skull base (SB) surgery have led to the resection of increasingly larger cranial base lesions, resulting in large SB defects. These defects have initially led to increased postoperative cerebrospinal fluid (CSF) leaks. The development of the vascularized pedicled nasoseptal fl...

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Main Authors:	Husain, Qasim, Sanghvi, Saurin, Kovalerchik, Olga, Shukla, Pratik A., Choudhry, Osamah J., Liu, James K., Eloy, Jean Anderson
Format:	Online
Language:	English
Published:	OceanSide Publications, Inc. 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679564/

id	pubmed-3679564
recordtype	oai_dc
spelling	pubmed-36795642013-06-14 Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects Husain, Qasim Sanghvi, Saurin Kovalerchik, Olga Shukla, Pratik A. Choudhry, Osamah J. Liu, James K. Eloy, Jean Anderson Articles Advances in endoscopic skull base (SB) surgery have led to the resection of increasingly larger cranial base lesions, resulting in large SB defects. These defects have initially led to increased postoperative cerebrospinal fluid (CSF) leaks. The development of the vascularized pedicled nasoseptal flap (PNSF) has successfully reduced postoperative CSF leaks. Mucocele formation, however, has been reported as a complication of this technique. In this study, we analyze the incidence of mucocele formation after repair of SB defects using a PNSF. A retrospective review was performed from December 2008 to December 2011 to identify patients who underwent PNSF reconstruction for large ventral SB defects. Demographic data, defect site, incidence of postoperative CSF leaks, and rate of mucocele formation were collected. Seventy patients undergoing PNSF repair of SB defects were identified. No postoperative mucocele formation was noted at an average radiological follow-up of 11.7 months (range, 3–36.9 months) and clinical follow-up of 13.8 months (range, 3–38.9 months), making the overall mucocele rate 0%. The postoperative CSF leak rate was 2.9%. Proper closure of SB defects is crucial to prevent CSF leaks. The PNSF is an efficient technique for these repairs. Although this flap may carry an inherent risk of mucocele formation when placed over mucosalized bone during repair, we found that meticulous and strategic removal of mucosa from the site of flap placement resulted in a 0% incidence of postoperative mucocele formation in our cohort. OceanSide Publications, Inc. 2013 2013-05-14 /pmc/articles/PMC3679564/ /pubmed/23772323 http://dx.doi.org/10.2500/ar.2013.4.0050 Text en Copyright © 2013, OceanSide Publications, Inc., U.S.A. This publication is provided under the terms of the Creative Commons Public License ("CCPL" or "License"), in attribution 3.0 unported (Attribution Non-Commercial No Derivatives (CC BY-NC-ND)), further described at: http://creativecommons.org/licenses/by-nc-nd/3.0/legalcode. The work is protected by copyright and/or other applicable law. Any use of the work other then as authorized under this license or copyright law is prohibited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Husain, Qasim Sanghvi, Saurin Kovalerchik, Olga Shukla, Pratik A. Choudhry, Osamah J. Liu, James K. Eloy, Jean Anderson
spellingShingle	Husain, Qasim Sanghvi, Saurin Kovalerchik, Olga Shukla, Pratik A. Choudhry, Osamah J. Liu, James K. Eloy, Jean Anderson Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects
author_facet	Husain, Qasim Sanghvi, Saurin Kovalerchik, Olga Shukla, Pratik A. Choudhry, Osamah J. Liu, James K. Eloy, Jean Anderson
author_sort	Husain, Qasim
title	Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects
title_short	Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects
title_full	Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects
title_fullStr	Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects
title_full_unstemmed	Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects
title_sort	assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects
description	Advances in endoscopic skull base (SB) surgery have led to the resection of increasingly larger cranial base lesions, resulting in large SB defects. These defects have initially led to increased postoperative cerebrospinal fluid (CSF) leaks. The development of the vascularized pedicled nasoseptal flap (PNSF) has successfully reduced postoperative CSF leaks. Mucocele formation, however, has been reported as a complication of this technique. In this study, we analyze the incidence of mucocele formation after repair of SB defects using a PNSF. A retrospective review was performed from December 2008 to December 2011 to identify patients who underwent PNSF reconstruction for large ventral SB defects. Demographic data, defect site, incidence of postoperative CSF leaks, and rate of mucocele formation were collected. Seventy patients undergoing PNSF repair of SB defects were identified. No postoperative mucocele formation was noted at an average radiological follow-up of 11.7 months (range, 3–36.9 months) and clinical follow-up of 13.8 months (range, 3–38.9 months), making the overall mucocele rate 0%. The postoperative CSF leak rate was 2.9%. Proper closure of SB defects is crucial to prevent CSF leaks. The PNSF is an efficient technique for these repairs. Although this flap may carry an inherent risk of mucocele formation when placed over mucosalized bone during repair, we found that meticulous and strategic removal of mucosa from the site of flap placement resulted in a 0% incidence of postoperative mucocele formation in our cohort.
publisher	OceanSide Publications, Inc.
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679564/
_version_	1611985566516117504

Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects

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