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J Neurol Surg B Skull Base 2017; 78(02): 201-206
DOI: 10.1055/s-0036-1597086
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Free Mucosal Graft Reconstruction of the Septum after Nasoseptal Flap Harvest: A Novel Technique Using a Posterior Septal Free Mucosal Graft

Frederick Yoo
1   Department of Head and Neck Surgery, UCLA David Geffen School of Medicine, Los Angeles, California, United States
,
Edward C. Kuan
1   Department of Head and Neck Surgery, UCLA David Geffen School of Medicine, Los Angeles, California, United States
,
Marvin Bergsneider
2   Department of Neurosurgery, UCLA David Geffen School of Medicine, Los Angeles, California, United States
,
Marilene B. Wang
1   Department of Head and Neck Surgery, UCLA David Geffen School of Medicine, Los Angeles, California, United States
› Author Affiliations
Further Information

Publication History

13 April 2016

14 October 2016

Publication Date:
09 December 2016 (online)

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Abstract

Objectives The nasoseptal flap (NSF) has become the workhorse for reconstruction in endoscopic endonasal skull-base surgery. The NSF, though useful in reconstruction, may lead to significant donor site morbidity. Published techniques to reduce the donor site morbidity, free mucosal grafts, and septal rotational flaps have shown to reduce crusting and remucosalization times. We present a novel technique utilizing posterior septal mucosa as a free mucosal graft for reconstruction of the anterior septal donor site. The septal mucosal graft is taken from the mucosa overlying the posterior septectomy site of the endonasal approach to skull base tumors.

Design Retrospective chart review.

Setting Single tertiary academic medical center.

Participants All patients who underwent endoscopic endonasal skull-base surgery between November 1, 2014 and August 30, 2015 with free mucosal graft reconstruction of the NSF donor site.

Main Outcome Measures Postoperative graft success.

Results Fifteen patients underwent septal reconstruction using a septal free mucosal graft. There was a 100% graft success rate with near complete remucosalization by 6 weeks postoperatively.

Conclusions The posterior septal free mucosal graft is a simple, reliable method for reconstructing the NSF donor site. The advantages of this technique include utilization of native septal mucosal tissue and middle turbinate preservation.

Keywords

skull base/surgery - skull base/pathology - nasal septum/surgery - nasal cavity/surgery - nasal mucosa/transplantation

Note

This paper was presented as a podium presentation at the North American Skull Base Society Meeting in Scottsdale, AZ on February 12–14, 2016.


 

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