Anatomy of the posterior septal artery with surgical implications on the vascularized pedicled nasoseptal flap.
BACKGROUND
The purpose of this study was to define the anatomic characteristics of the posterior septal artery related to the design of the vascularized pedicled nasoseptal flap.


METHODS
The course and branching pattern of the posterior septal artery and its relationship with landmarks and other regional arteries were studied in 26 vascular latex-injected head sides.


RESULTS
The posterior septal artery is divided into 2 septal branches within the sphenoidal segment, which occurred either close to the sphenopalatine foramen (65.4%) or at the posterior border of the nasal septum (34.6%). The inferior branch was frequently dominant (61.5%). The dominant branch was always below the axial plane of the sphenoid ostium. On the posterior nasal septum, the inferior branch may run downward before coursing anteroinferiorly.


CONCLUSIONS
We identify 2 high-risk areas for the design of the vascularized PNSF, namely, at the inferior aspect of the sphenoid ostium and the junction of the posterior nasal septum and the choana arch.
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.|Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
Xian
X
Zhang
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Eric W
EW
Wang
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Hongquan
H
Wei
Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
Jin
J
Shi
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Carl H
CH
Snyderman
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Paul A
PA
Gardner
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Juan C
JC
Fernandez-Miranda
D000328:Adult; D001158:Arteries / Q000601:surgery; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000098:blood supply* / Q000601:surgery; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D019291:Skull Base / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*
anatomy; endoscopic endonasal approach; nasoseptal flap; reconstruction; skull base