Skip to main content

Advertisement

SpringerLink
Log in

Reconstruction of the denuded nasoseptal flap donor site with a free fascia lata graft: technical note

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The nasoseptal flap provides hearty vascularized tissue for the reconstruction of skull base defects subsequent to expanded endonasal approaches; however, it leads to exposure of the cartilage at the septal donor site producing crusting and discomfort while it remucosalizes. We report an alternative technique to reconstruct the denuded nasal septal donor site by means of a free fascia lata graft. Fascia lata grafting of the nasoseptal flap donor site showed evidence of revascularization 4 weeks after initial surgery. Re-epithelialization was complete 4–12 weeks postoperation. Although the nasoseptal flap provides a versatile reconstructive technique, its harvest results in significant donor site morbidity. A free fascia lata graft accelerates the rate of donor site remucosalization; thus, decreasing the nasal complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Eloy JA, Vivero RJ, Hoang K et al (2009) Comparison of transnasal endoscopic and open craniofacial resection for malignant tumors of the anterior skull base. Laryngoscope 119:834–840

    Article  PubMed  Google Scholar 

  2. Kimple AJ, Derek Leight W, Wheless SA, Zanation AM (2012) Reducing nasal morbidity after skull base reconstruction with the nasoseptal flap: free middle turbinate mucosal grafts. Laryngoscope 122:1920–1924

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hadad G, Bassagaisteguy L, Carrau RL et al (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116:1882–1886

    Article  PubMed  Google Scholar 

  4. Pinheiro-Neto CD, Snyderman CH (2013) Nasoseptal flap. Adv Otorhinolaryngol 74:42–55

    PubMed  Google Scholar 

  5. McCoul ED, Anand VK, Singh A, Nyquist GG, Schaberg MR, Schwartz TH (2014) Long-term effectiveness of a reconstructive protocol using the nasoseptal flap after endoscopic skull base surgery. World Neurosurg 81:136–143

    Article  PubMed  Google Scholar 

  6. Liu JK, Schmidt RF, Choudhry OJ, Shukla PA, Eloy JA (2012) Surgical nuances for nasoseptal flap reconstruction of cranial base defects with high-flow cerebrospinal fluid leaks after endoscopic skull base surgery. Neurosurg Focus 32:E7

    Article  PubMed  Google Scholar 

  7. Zanation AM, Carrau RL, Snyderman CH et al (2009) Nasoseptal flap reconstruction of high flow intraoperative cerebral spinal fluid leaks during endoscopic skull base surgery. Am J Rhinol Allergy 23:518–521

    Article  PubMed  Google Scholar 

  8. Charalampaki P, Ayyad A, Kockro RA, Perneczky A (2009) Surgical complications after endoscopic transsphenoidal pituitary surgery. J Clin Neurosci 16:786–789

    Article  PubMed  Google Scholar 

  9. Laws ER, Kern EB (1976) Complications of trans-sphenoidal surgery. Clin Neurosurg 23:401–416

    PubMed  Google Scholar 

  10. Black PM, Zervas NT, Candia GL (1987) Incidence and management of complications of transphenoidal operation for pituitary adenomas. Neurosurgery 20:920–924

    Article  CAS  PubMed  Google Scholar 

  11. Soudry E, Psaltis AJ, Lee KH et al (2015) Complications associated with the pedicled nasoseptal flap for skull base reconstruction. Laryngoscope 125:80–85

    Article  PubMed  Google Scholar 

  12. Kasemsiri P, Carrau RL, Otto BA et al (2013) Reconstruction of the pedicled nasoseptal flap donor site with a contralateral reverse rotation flap: technical modifications and outcomes. Laryngoscope 123:2601–2604

    Article  PubMed  Google Scholar 

  13. Kassam AB, Thomas A, Carrau RL et al (2008) Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap. Neurosurgery 63(1 suppl 1):ONS44–ONS52 (discussion ONS52–ONS53)

    PubMed  Google Scholar 

  14. Cogswell LK, Goodacre TE (2000) The management of nasoseptal perforation. Br J Plast Surg 53:117–120

    Article  CAS  PubMed  Google Scholar 

  15. Quetz J, Ambrosch P (2011) Total nasal reconstruction: a 6-year experience with the three-stage forehead flap combined with the septal pivot flap. Facial Plast Surg 27:266–275

    Article  CAS  PubMed  Google Scholar 

  16. Gagliardi F, Boari N, Mortini P (2011) Reconstruction techniques in skull base surgery. J Craniofac Surg 22:1015–1020

    Article  PubMed  Google Scholar 

  17. Crawford JS (1968) Fascia lata: its nature and fate after implantation and its use in ophthalmic surgery. Trans Am Ophthalmol Soc 66:673–745

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Dubiel WT, Wigren A (1974) Functional status of the lower extremity after resection of fascia lata. Acta Orthop Scand 45:599–613

    Article  CAS  PubMed  Google Scholar 

  19. McCarthy JG (1990) Plastic surgery, vol 1. W B Saunders, Philadelphia, pp 522–523

    Google Scholar 

  20. Wheatcroft SM, Vardy SJ, Tyers AJ (1997) Complications of fascia lata harvesting for ptosis surgery. Br J Ophthalmol 81:581–583

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Dr. Zahid Hussain Khan for editing this manuscript.

Author information

Authors and Affiliations

  1. Brain and Spinal Cord Injuries Repair Research Center (BASIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blv., Tehran, 1419733141, Iran

    Mehdi Zeinalizadeh

  2. Department of Neurological Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Mehdi Zeinalizadeh

  3. Department of Otolaryngology-Head and Neck Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Seyed Mousa Sadrehosseini

  4. Department of Neurological Surgery, John Wayne Cancer Institute at Saint John’s Health Center, Santa Monica, CA, USA

    Garni Barkhoudarian

  5. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA

    Ricardo L. Carrau

Authors
  1. Mehdi Zeinalizadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seyed Mousa Sadrehosseini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Garni Barkhoudarian
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ricardo L. Carrau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mehdi Zeinalizadeh.

Ethics declarations

Conflict of interest

There is no conflict of interest to be declared.

Funding statement

The manuscript is funded by the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zeinalizadeh, M., Sadrehosseini, S.M., Barkhoudarian, G. et al. Reconstruction of the denuded nasoseptal flap donor site with a free fascia lata graft: technical note. Eur Arch Otorhinolaryngol 273, 3179–3182 (2016). https://doi.org/10.1007/s00405-016-3962-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-016-3962-0

Keywords

Search

Navigation