Perforation of a nasoseptal flap does not increase the rate of postoperative cerebrospinal fluid leak. Issue 4 (26th January 2015)

• Record Type: Journal Article
• Authors: Huntley, Colin; Iloreta, Alfred Marc Calo; Nyquist, Gurston G.; Otten, Marc; Garcia, Hermes; Farrell, Christopher; Rosen, Marc R.; Evans, James J.
• Is Part Of: International forum of allergy & rhinology. Volume 5:Issue 4(2015:Apr.)
• Page Start: 353
• Page End: 355
• Publication Date: 2015-01-26
• Subjects: 617.51005
• DOI: 10.1002/alr.21480
• Languages: English
• ISSNs: 2042-6976

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="alr21480-sec-0010" sec-type="section"> <title>Background</title> <p>The nasoseptal flap (NSF) has been shown to be a valuable addition to the reconstructive armamentarium of the endoscopic skull‐base surgeon. We aimed to evaluate the rate of postoperative cerebrospinal fluid (CSF) leak after use of a NSF that had a small tear during harvest.</p> </sec> <sec id="alr21480-sec-0020" sec-type="section"> <title>Methods</title> <p>After Institutional Review Board (IRB) approval, we analyzed our database of patients undergoing skull‐base resection. We included all patients who had a NSF reconstruction, septoplasty, and/or spur on preoperative computed tomography (CT) imaging. We then evaluated video of each procedure to determine if a tear occurred in the NSF during harvest. Patient records were reviewed to determine if a postoperative CSF leak occurred.</p> </sec> <sec id="alr21480-sec-0030" sec-type="section"> <title>Results</title> <p>We evaluated video of 21 patients who underwent a skull‐base resection, were reconstructed with a NSF, and had either a septoplasty or evidence of a septal spur on CT imaging. Of these 21 cases, 11 small tears occurred during harvest of the NSF flap and none of the patients with a torn NSF had a postoperative CSF leak.</p> </sec> <sec id="alr21480-sec-0040" sec-type="section"> <title>Conclusion</title> <p>Our series shows a 0% postoperative CSF leak rate in patients undergoing skull‐base reconstruction with a NSF that was torn during harvest. Small tears in the NSF do not seem to affect postoperative CSF leak rates.</p> </sec> </abstract>