METHOD FOR ENDOSCOPIC ENDONASAL PLASTIC CLOSURE OF SKULL BASE ANTERIOR DIVISION CSF FISTULA BY MUCOPERIOSTEAL SEPTAL FLAP

摘要

FIELD: medicine.;SUBSTANCE: bone bed in the area of the anterior skull base bone defect is prepared, then two horizontal nasal septum mucoperiosteal incisions are made, starting at the front end of the middle turbinate and ending near its rear end. The upper incision is made at the turbinate shoulder level, keeping the olfactory epithelium. The lower one passes at the free edge of the middle turbinate, climbing 1 cm upwards, while a narrow pedicle comprising a rear grid artery of the internal carotid artery system is formed in the rear-upper parts of the nasal septum. The front vertical incision connects the front edges of horizontal incisions. The mucoperiosteal flap is separated to form a pedicle supplied by the rear grid artery of the internal carotid artery system. Mucosa flap is rotated, oriented outwards and laid on the prepared bone followed by fixing.;EFFECT: method allows reliable reconstruction of small anterior skull base defects of slit-like shape in a complex surgical corridor geometry with minimal damage to the donor.;1 dwg,1 ex