Perforation of a nasoseptal flap does not increase the rate of postoperative cerebrospinal fluid leak

Colin Huntley, Alfred Marc Calo Iloreta, Gurston G. Nyquist, Marc Otten, Hermes Garcia, Christopher Farrell, Marc R. Rosen, James J. Evans

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)353-355
Number of pages3
JournalInternational Forum of Allergy and Rhinology
Volume5
Issue number4
DOIs
StatePublished - 1 Apr 2015
Externally publishedYes

Keywords

  • CSF leak
  • NSF
  • Nasoseptal flap
  • Septoplasty
  • Skull-base reconstruction

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