ObjectiveTo introduce the method to repair skull base defect using buttontyped nasoseptal mucosalcartilage flap under endoscope, and to detect the efficacy and indications of this repair method.MethodsClinical data of 16 cases of skull base defect caused by neoplasm resection and repaired with buttontyped nasoseptal mucosalcartilage flap was analyzed retrospectively. The resected neoplasms included olfactory neuroblastoma (5 cases), craniopharyngioma (2 cases), pituitary tumor (5 cases), meningioma (3 cases) and germ cell tumor (one case). The range of nasoseptal flap was calculated based on that of the defect. An integral flap of mucosa and cartilage on one side of the nasal septum was harvested. The isolated flap was further modified and annularly sutured to prevent avulsion. A dissection reconstruction was performed by inserting the cartilage of the flap into the inner surface of the defect and tiling the mucosa on the outer surface.ResultsSuccessful reconstruction was achieved in all cases at once without any postoperative complications such as cerebrospinal fluid rhinorrhea or intracranial infection. Postoperative radiotherapy was applied to 5 olfactory neuroblastoma patients and the germ cell tumor case with followup periods of 6 months or more. Other cases without postoperative radiotherapy were followed up for 6 months to 5 years. No cerebrospinal fluid rhinorrhea or intracranial infection occurred during the followup period in all cases.ConclusionsIt is a reliable method to reconstruct the skull base defect with buttontyped nasoseptal mucosalcartilage flap under nasal endoscope.
