Utilising Free Middle Turbinate Mucosal Grafts to Reconstruct the Septal Donor Site Following Nasoseptal Flap Harvesting in Endoscopic Endonasal Approach for Sellar and Parasellar Lesions

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-01-29 DOI:10.1111/coa.14287

Chin-Hsuan Liu, Tsai Shan Lin, Yu-Wen Huang, Chien-Fu Yeh, Li-Ting Hung, Ming-Ying Lan, Wei-Hsin Wang

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引用次数: 0

Abstract

Introduction

The nasoseptal flap (NSF) has become a widely favoured choice for reconstructing skull base defects following the endoscopic endonasal approach (EEA). However, the exposed septal cartilage and bone at the donor site often require an extended duration for secondary healing. This study investigated whether the free middle turbinate (MT) mucosa grafting at the septal donor site could mitigate post-operative nasal morbidity.

Methods

We retrospectively reviewed patients with sellar and parasellar lesions who underwent NSF harvesting in EEA between 2015 and 2023. In most cases, the MT mucosa was harvested as a free mucosal graft and placed on the exposed nasal septal donor site. The degree of septal mucosalisation and the presence of nasal crusting were assessed during follow-up appointments.

Results

A total of 104 patients were included in this study, comprising 41 males and 63 females. All patients underwent NSF harvesting for skull base defect reconstruction and 99 patients received MT mucosa grafting at the septal donor site. The average duration for complete mucosalisation of the exposed septal cartilage with the MT graft was 38.7 days, significantly different from 59.6 days for patients without the MT graft (p < 0.0001). At the 3-month post-operative follow-up, 34% of the patients with MT graft displayed no crusting compared to 20% of patients without MT graft.

Conclusions

The use of free MT mucosal grafting represents a promising technique for improving mucosalization and minimising crusting at the nasal septal donor site following the harvest of the NSF in EEA for sellar and parasellar lesions.

查看原文本刊更多论文

鼻内窥镜鼻内入路鼻中隔皮瓣切除治疗鞍区及鞍旁病变后，应用游离中鼻甲粘膜移植重建鼻中隔供区。

鼻中隔瓣（NSF）已成为内镜鼻内入路（EEA）后颅底缺损重建的广泛选择。然而，供体部位暴露的中隔软骨和骨通常需要较长的时间进行二次愈合。本研究探讨在鼻中隔供区游离中鼻甲（MT）粘膜移植是否可以减轻术后鼻部并发症。方法：我们回顾性分析了2015年至2023年间在EEA接受NSF切除的鞍区和鞍旁病变患者。在大多数情况下，MT粘膜作为游离粘膜移植物被收获，并放置在暴露的鼻中隔供体部位。在随访期间评估鼻中隔粘膜化程度和鼻结皮的存在。结果：共纳入104例患者，其中男性41例，女性63例。所有患者均行NSF切除颅底缺损重建，99例患者在鼻中隔供区行MT粘膜移植。移植鼻中隔软骨完全粘膜化的平均持续时间为38.7天，明显不同于未移植鼻中隔软骨的患者的59.6天(p结论：在EEA的鞍区和鞍旁病变中收获NSF后，使用游离鼻中隔粘膜移植是一种很有前途的技术，可以改善鼻中隔供体部位的粘膜化和减少结痂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.