PMID- 19718761
OWN - NLM
STAT- MEDLINE
DCOM- 20091123
LR  - 20091029
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 119
IP  - 11
DP  - 2009 Nov
TI  - Middle turbinate flap for skull base reconstruction: cadaveric feasibility study.
PG  - 2094-8
LID - 10.1002/lary.20226 [doi]
AB  - OBJECTIVES/HYPOTHESIS: Surgical resection of intradural pathology through an 
      endonasal corridor creates defects that communicate the subarachnoid space with 
      the sinonasal tract. Reconstruction of these defects with vascularized tissue is 
      superior to any other method. The purpose of this study is to describe a novel 
      vascularized pedicled flap from the middle turbinate (MT) mucosa and to assess 
      its feasibility using a cadaveric model. METHODS: Twelve middle turbinate flaps 
      (MTFs) were raised in six fresh cadaveric heads previously injected with colored 
      silicone. Arteries supplying the MT were identified as the turbinate 
      mucoperiosteum was harvested from both its medial and lateral aspects. Length and 
      surface area of the flaps, as well as their ability to cover dural defects of the 
      sella, planum sphenoidale, and fovea ethmoidalis reach were noted. RESULTS: All 
      MTFs adequately covered defects of the planum and fovea ethmoidalis; however, two 
      of the twelve MTFs were not suitable to cover a sellar defect. The mean surface 
      area of the MTFs was 5.6 cm(2). As an independent factor surface area did not 
      correlate with the ability of the flap to cover the sellar defects. However, 
      those flaps that were not suitable for sellar repair were less than 4.0 cm in 
      length. CONCLUSIONS: Harvesting of a vascular pedicle flap from the MT is 
      feasible, albeit technically demanding. It should be considered as an alternative 
      for the reconstruction of small defects of the fovea ethmoidalis, planum, and 
      sella, particularly for patients for whom a reconstruction with vascularized 
      tissue is desirable but the nasoseptal flap is not available.
FAU - Prevedello, Daniel M
AU  - Prevedello DM
AD  - Department of Neurosurgery, University of Pittsburgh School of Medicine, 
      Pittsburgh, Pennsylvania, USA.
FAU - Barges-Coll, Juan
AU  - Barges-Coll J
FAU - Fernandez-Miranda, Juan Carlos
AU  - Fernandez-Miranda JC
FAU - Morera, Victor
AU  - Morera V
FAU - Jacobson, Deborah
AU  - Jacobson D
FAU - Madhok, Ricky
AU  - Madhok R
FAU - dos Santos, Marco C J
AU  - dos Santos MC
FAU - Zanation, Adam
AU  - Zanation A
FAU - Snyderman, Carl H
AU  - Snyderman CH
FAU - Gardner, Paul
AU  - Gardner P
FAU - Kassam, Amin B
AU  - Kassam AB
FAU - Carrau, Ricardo
AU  - Carrau R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Cadaver
MH  - Feasibility Studies
MH  - Humans
MH  - Skull Base/*surgery
MH  - *Surgical Flaps
MH  - Turbinates/*transplantation
EDAT- 2009/09/01 06:00
MHDA- 2009/12/16 06:00
CRDT- 2009/09/01 09:00
PHST- 2009/09/01 09:00 [entrez]
PHST- 2009/09/01 06:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - 10.1002/lary.20226 [doi]
PST - ppublish
SO  - Laryngoscope. 2009 Nov;119(11):2094-8. doi: 10.1002/lary.20226.