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Pedicled nasal flaps in transnasal endoscopic surgery: review of indications and surgical techniques

机译:经鼻内窥镜手术中的带蒂鼻瓣:适应证和手术技术综述

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摘要

At present an exclusive endoscopic endonasal approach is sufficient in the majority of cases to treat pathologies involving the sinonasal compartment and the surrounding anatomical subsites (e.g. orbit, ventral skull base, upper parapharyngeal space, etc.) with the advantage of minimising surgical invasiveness. In this context, nasal vascularised local flaps are widely employed because they represent a more effective option for reconstruction or preservation of noble/vital structures compared to grafts. On the other hand, the surgical extension and morbidity are minimised compared to regional or free flaps. Several nasal local flaps have been described in the literature: the aim of this review is to examine their applications, characteristics, indications, success rates and morbidities. Different nasal flaps based on single or multiple pedicles have been described; the choice between them is based on different factors such as the flap’s shape and dimension, localisation of the pedicle’s origin, width of rotation angle, previous surgeries which could compromise vascularisation, and surgical experience, in addition to the position and dimension of the area which must be resurfaced.
机译:目前,在大多数情况下,独家内窥镜鼻内入路足以治疗涉及鼻窦隔室和周围解剖亚部位(例如 眼眶、腹侧颅底、上咽旁间隙等)的病变,其优点是手术侵入性最小。在这种情况下,鼻血管化局部皮瓣被广泛使用,因为与移植物相比,它们代表了重建或保存贵族/重要结构的更有效选择。另一方面,与区域或游离皮瓣相比,手术延长和并发症发生率降至最低。文献中已经描述了几种鼻局部皮瓣:本综述的目的是检查它们的应用、特征、适应症、成功率和发病率。已经描述了基于单个或多个蒂的不同鼻瓣;它们之间的选择基于不同的因素,例如皮瓣的形状和尺寸、椎弓根起源的位置、旋转角度的宽度、可能影响血管形成的先前手术和手术经验,以及必须重新表面的区域的位置和尺寸。

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