Feasibility of the nasoseptal flap for reconstruction of large anterior skull base defects in Asians

Abstract

Conclusion: Reconstruction of a large anterior skull base defect (SBD) with the nasoseptal flap (SF) is feasible in Asians. We consider the width of the SF to be the determining factor. Increasing flap width by incorporating the mucoperiosteum of the nasal floor can compensate for the relatively small septum in Asians. Objectives: To assess the feasibility of the SF for reconstruction of large anterior SBD in Koreans, and attempt to provide tips for improving its design. Methods: Radioanatomic measurements and intraoperative findings were analyzed. Specific skull base landmarks were measured to estimate the anticipated SBD and actual SBD. The length and width of the potential SF dimension was also measured and compared with the defect size to assess its feasibility. Results: The lengths of the actual SBDs were longer than those of anticipated SBDs in all patients, while the width of actual SBDs showed less discrepancy. Length and anterior width of the potential SF exceeded the needed SF dimensions in two patients, while the posterior width of potential SF fell short of the needed dimension. In both patients, the length of harvested SF was long enough to repair the entire length of SBD, while shortage of SF width was encountered in one patient.

Keywords::

• Hadad-Bassagastegy flap
• radioanatomic study
• pedicled septal flap
• septum size

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.