Nasal and Skull Base Reconstruction with Turbinate Flaps

Authors: Gallino N, Serrano C and Ruggeri CS*

DOI: 10.23880/ooaj-16000274

Volume 8, Issue 2

Abstract

Introduction: The reconstruction of the skull base and nasal mucosa can be performed using different local flaps. The use of the nasoseptal flap is the most common method to reconstruct these areas, but sometimes, due to septal perforations, a history of previous surgeries that may have damaged its pedicle, or because its rotational arc is not ideal, other nasal flaps such as those from the inferior or middle turbinate with their various pedicles may need to be employed. Objectives: The aim of this study was to ascertain the success rate of reconstructions involving the nasal cavity and skull base utilizing inferior and middle turbinate flaps. Methods: Data collected prospectively were analyzed using an Excel spreadsheet for patients who underwent skull base and nasal cavity defect repairs employing turbinate flaps between May 2014 and August 2021. Results: Nine patients were treated and a total of ten reconstructions were performed. Five middle turbinate flaps were executed, two involving medial rotation to address defects situated on the ethmoid roof and three involving lateral rotation to repair a defect within the ethmoid fovea, with two of these flaps closing the frontal ostium. Furthermore, an inferior turbinate flap with a posterior pedicle was utilized to repair the defect resulting from the resection of a meningocele, which was located on the ethmoid roof. Four lateral wall flaps with an anterior pedicle were employed to reconstruct the mucosa of the nasal cavity and to address a defect in the anterior skull base. Conclusion: The reconstruction of anterior skull base defects using turbinate flaps was highly satisfactory, achieving a 100% success rate. The use of lateral wall flaps to repair defects produced by rhinectomies that included resection of the nasal mucosa was also successful and we did not have partial or total necrosis of the flaps. The excellent blood supply to the lateral nasal walls and the ability to dissect these flaps with different arterial pedicles and extend their surface, including the nasal floor, allows for various flap rotations and the reconstruction of defects of different sizes.

Keywords: Turbinate Flap; Skull Base; Cerebrospinal Fluid Fistula; Reconstruction

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