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Long-Term Outcome of Endonasal Endoscopic Skull Base Reconstruction with Nasal Turbinate Graft
Authors:Omar A El-Banhawy  Ahmed N Halaka  Mohammed A Altuwaijri  Heshmat Ayad  and Mohamed M El-Sharnoby
Institution:1.Department of ENT, Faculty of Medicine, El Menoufyia University, El Menoufyia, Egypt;2.Department of Neurosurgery, EI-Hikmah Hospital, El-Mansoura, Egypt;3.Al Iman General Hospital Riyadh, Kingdome of Saudi Arabia;4.Department of ENT, Faculty of Medicine, Ain Shames University, Cairo, Egypt
Abstract:Objective: To study the long-term outcome of endonasal endoscopic skull base reconstruction with nasal turbinate tissue free graft. Patients and Methods: This study included 55 consecutive patients who underwent endonasal endoscopic skull base reconstruction with nasal turbinate graft and were available for follow-up. They were 30 patients with pituitary adenomas, 20 with cerebrospinal fluid (CSF) rhinorrhea of different etiologies, three with meningoencephalocele, and two with skull base meningiomas. Autologous nasal turbinate tissue materials were used in reconstructing the skull base defect. Clinical follow-up with endoscopic nasal examination was done routinely 1, 3, 6, and 12 months after surgery. Computed tomography and magnetic resonance imaging were performed when indicated. The follow-up period ranged from 6 months to 8 years. Results: There were no major operative or postoperative complications. Nasal turbinate graft was effective in sealing of intraoperative CSF leak, obliteration of dead space, and anatomic reconstruction of the skull base. There was no evidence of graft migration or inflammatory changes. Starting from 3 months after surgery to the rest of the follow-up period, endonasal endoscopic view of the site of duraplasty showed that: with small skull base defect (less than 5 mm), there was neither dural pulsation nor prolapse; with moderate-sized defect (5 to 10 mm), there was dural pulsation without prolapse; with larger defect (>
Keywords:Endonasal  endoscopic  skull base  nasal turbinate
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