Middle turbinate mucosal flap: Low-morbidity option in the management of skull base defects

Abstract

Background: To describe the low morbidity of middle turbinate mucosal flap (MTMF) to repair anterior skull base defects.

Methods: Skull base endonasal endoscopic surgeries performed at a tertiary hospital between 2015 and 2018 were analyzed. Patients were divided into two groups according the existence or not of a significant intraoperative cerebrospinal fluid (CSF) leak. In Group 1 (n = 28), gasket seal and a pedicled endonasal flap were used to repair the defect: 13 nasoseptal flaps (NSF), 8 inferolateral wall flaps (ILF), and 7 MTMF. In Group 2 only an endonasal flap was used: 9 NSF, 4 ILF, and 18 MTMF. Surgical and recovery time were analyzed (Student's t test). Our favorite surgical technique is described.

Results: Fifty-nine patients were included. Average surgical time was 27.7, 41.6, and 11.3 min for NSF, ILF, and MTMF, respectively. MTMF showed a faster recovery.

Conclusion: MTMF is a safe reconstructive option for anterior skull base defects.

Keywords: endoscopic skull base; middle turbinate; nasoseptal flap; skull base; skull base surgery.