[Pedicle flaps based on the sphenopalatine artery: anatomical and surgical study].
BACKGROUND
Local pedicle flaps based on the sphenopalatine artery make it possible to reconstruct large defects of the skull base (SB).


METHODS
From January 2008 to January 2013, 64 lesions with involvement of SB were analysed. These lesions were treated using endoscopic endonasal approach and required a pedicle flap based on the sphenopalatine artery. In addition, measurements and flexibility of the flaps were examined in 4 cadaveric nasal cavities.


RESULTS
Surgical group. Sixty-four nasoseptal flaps (NSF) were used, in 4 cases associated with a middle turbinate flap (MTF), and in 1 case supplemented with an inferior turbinate flap (ITF). Five cerebrospinal fluid fistulas (8%) were noted. Among patients with initial lesions, 7% presented an anosmia. Cadaveric group. The length of the NSF varied between 5.2 cm and 7.7 cm and the width ranged from 3 cm to 4.5 cm. The ITF provided an anterior-posterior distance between 4.2 cm and 5 cm, with a width between 1.2 cm and 2.8 cm. The mean length of MTFs varied between 3.5 cm and 4.2 cm, with a width between 1.4 cm and 1.9 cm.


CONCLUSIONS
The most versatile local flap for the reconstruction of skull base defects is the NSF, and flaps pedicled to the posterolateral nasal artery offer an excellent alternative.
Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: jgras@santpau.cat.
Juan R
JR
Gras-Cabrerizo
Servicio de Otorrinolaringología, Hospital General Universitario, Universidad Miguel Hernández, Alicante, España.
Juan R
JR
Gras-Albert
Servicio de Otorrinolaringología, Hospital General Universitario, Universidad Miguel Hernández, Alicante, España.
Irene
I
Monjas-Canovas
Servicio de Radiología, Hospital General Universitario, Universidad Miguel Hernández, Alicante, España.
Elena
E
García-Garrigós
Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España.
Joan R
JR
Montserrat-Gili
Unidad de Anatomía y Embriología Humana, Universidad Miguel Hernández, Alicante, España.
Francisco
F
Sánchez del Campo
Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España.
Katarzyna
K
Kolanczak
Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España.
Humbert
H
Massegur-Solench
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D055815:Young Adult
Arteria esfenopalatina; Base del cráneo; Cirugía endoscópica; Colgajos pediculados; Endoscopic surgery; Pedicle flaps; Skull base; Sphenopalatine artery