Bilateral Posterior Nasoseptal Flap - Double Breasting Technique

xlomafota13 shared this article with you from Inoreader Bilateral Posterior Nasoseptal Flap - Double Breasting Technique Via leak of cerebrospinal fluid Neurol India. 2021 Mar-Apr;69(2):307-310. doi: 10.4103/0028-3886.314538. ABSTRACT BACKGROUND AND INTRODUCTION: The success of endoscopic skull base surgery is largely based on the effective repair of the skull base defect. A pedicled nasoseptal flap (NSF), described by Hadad-Bassagateguy is the workhorse of contemporary endoscopic skull base repair. We describe a modification in the technique, "double breasting technique," using the bilateral posterior NSF for skull base repair. OBJECTIVE: In this video article, we describe the technique of harvesting bilateral posterior nasal septal flaps and overlaying the flaps in a double breasting technique to cover the skull base defect. The posterior NSF can be used to cover medium to large skull base defects effectively. SURGICAL TECHNIQUE: A 40-year-old female patient presented with headache and decreased vision for 2 months. MRI with gadolinium showed a sellar suprasellar lesion with chi asmal compression. Visual field charting showed bitemporal hemianopia. She underwent endoscopic transnasal transsphenoidal surgery (binostril approach) and complete excision of tumor. Intraoperatively, there was evidence of arachnoid breach with high flow cerebrospinal fluid (CSF) leak. Sella was repaired with fat, fascia, fibrin glue, and overlaid with the bilateral posterior NSF in a double breasting technique, as described in the video. RESULTS: The skull base repair was successful, with no CSF leak postoperatively. PMID:33904440 | DOI:10.4103/0028-3886.314538 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.