Non-pedicled vs vascular pedicled nasal flap in repair of cerebrospinal fluid rhinorrhea

Abstract

Conclusions: In our study, pedicled nasal flap (NF) did not provide better results than free nasal graft (NG) for primary closure of cerebrospinal fluid (CSF) rhinorrhea. In the future, a multicenter randomized study would be needed to confirm this result. The choice of surgical technique will depend on the surgeon's experience, and the position and size of the defect. Objectives: To evaluate our results in repairing CSF leaks, comparing the two techniques we used: free NG and pedicled NF. Methods: A total of 33 patients diagnosed with CSF rhinorrhea were operated on between June 2000 and May 2010; 17 were women. The mean age was 44.7 years (± 13.0). Twenty-two (66.6%) NFs of the middle and lower turbinate and septum were performed, the rest being NGs of the middle and lower turbinate only. A descriptive statistical analysis and a Kaplan–Meier survival analysis were carried out and the log-rank statistic was used to compare both techniques. Results: In the present study, 78% of defects were closed in all cases; NF was used in 86% (19) and NG in 63.63% (7). The mean follow-up was 71.5 (95% confidence interval (CI), 56.9–86.1) months. There were no statistically significant differences (p > 0.05).

Keywords::

• Surgical flaps
• pedicled flaps
• free nasal graft
• CSF leak

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