Vega AA, Palma DM, Barges CJ, Gómez AJL, Alcocer BV

Language: Spanish
References: 9
Page: 154-162
PDF size: 284.89 Kb.

ABSTRACT

Objective: To compare the results of pedicle nasoseptal flat vs septal inverted in transnasal endoscopic surgery to extended approaches of skull base.
Patients and method: Fifty-two patients with different diseases of the skull base were studied, they were operated at National Institute of Neurology and Neurosurgery of Mexico by endonasal endoscopic way; patients had cephalorachideal liquid fistula of high spend, which was repaired applying the technique of pedicle nasoseptal flat. These patients were compared with a group of 50 patients, whose data were taken from the historic record of patients submitted to surgery by endonasal endoscopic way due to a disease of the skull base; patients also had cephalorachideal liquid fistula of high spend, which was repaired with flats free of fat, fascia and muscle.
Results: Out of the group of study of 52 patients managed with pedicle nasoseptal flat due to cephalorachideal liquid fistula (of high spend) after an endonasal endoscopic surgery of skull base, five patients had persistence of cephalorachideal liquid fistula after surgical procedure. Out of the control group of 50 patients managed with free flat (fat, fascia and muscle) due to cephalorachideal liquid fistula (of high spend) after an endonasal endoscopic surgery of skull base, 19 patients had persistence of cephalorachideal liquid fistula after surgical procedure. There was persistence of fistula in 9.6% of patients managed with pedicle nasoseptal flat vs 38% of persistence of fistula treated with free flat.
Conclusions: Pedicle nasoseptal flat is part of the surgical procedure of lesions of a great dorsal extension and that are considered communicate ventricular system and surgical site, which favors a fistula of a very high spend. In this study pedicle nasoseptal flat was superior than free flat, because there was lesser persistence of fistula with the pedicle nasoseptal flat.

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