A case of a pedicled middle turbinate mucosal flap useful for skull base reconstruction after transnasal endoscopic resection of a meningoencephalocele

DOI
  • MURAKAMI Daisuke
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
  • KUGA Daisuke
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • KOMUNE Noritaka
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
  • MUKAE Nobutaka
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • MIYAMOTO Yusuke
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
  • SUZUKI Tomoharu
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
  • SAITO Yuichi
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
  • HIGUCHI Ryota
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University
  • YOSHIMOTO Koji
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • NAKAGAWA Takashi
    Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University

Bibliographic Information

Other Title
  • 経鼻内視鏡下髄膜脳瘤切除術後の頭蓋底再建に有茎中鼻甲介粘膜弁が有用であった 1 例

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Description

<p>An 18-year-old male patient had developed epileptic seizures with loss of consciousness 3 years earlier, and despite subsequent drug treatment, he still had recurrent epileptic seizures. Imaging studies revealed a meningoencephalocele with protrusion of the temporal lobe from the middle cranial fossa to the lateral fossa of the sphenoid sinus. Since this was thought to be the focus of the temporal lobe epilepsy, he was admitted to our hospital for resection of the meningoencephalocele. The patient underwent transnasal endoscopic resection of the meningoencephalocele in the lateral fossa of the sphenoid bone, followed by multilayer skull base reconstruction using a pedicled middle turbinate mucosal (MT) flap. Postoperatively, the epileptic seizures disappeared, and the patient has recovered without cerebrospinal fluid leakage or wound complications. If the area is localized near the sphenopalatine foramen, such as the lateral fossa of the sphenoid sinus, an MT flap can be used instead of a nasal septal mucosal flap. Furthermore, by using a minimal transpterygoid approach and preserving the sphenopalatine artery and its branch, the middle turbinate artery, it was possible to use the MT flap during skull base reconstruction.</p>

Journal

  • jibi to rinsho

    jibi to rinsho 69 (2), 116-123, 2023-03-20

    JIBI TO RINSHO KAI

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