title: A unilateral septal flap based on the anterior ethmoidal artery (Castelnuovo's flap): CT cadaver study.
abstract: OBJECTIVE
  We describe our experience for repair septal perforation with a septal flap and we analyse the route of the septal branch of the anterior ethmoidal artery (AEA) in the septum area with a radiological anatomy study in order to perform this flap.
  
  
  METHODS
  We carry out a prospective analysis with computed tomography scan in the cadaver heads and we perform an endoscopic technique in the patients.
  
  
  METHODS
  Ten nasal cavities were analysed in five adult cadaveric heads and two patients diagnosed with anterior septal perforation were surgically treated. Measurements in the cadaveric heads were obtained from a sagittal plane of the nasal septum. The anterior point corresponds to the projection of the anterior insertion of the middle turbinate in the frontal process of the maxilla over the nasal septum. The posterior point was obtained with a vertical line passing through the entrance of the AEA in the nasal septum.
  
  
  RESULTS
  The mean distance between the anterior point and the posterior point was 7.35 mm with a standard deviation of 0.95 mm. The lowest value was 5.5 mm and the highest value was 8.7 mm. We observed good epithelialisation and closure of the perforation in all patients.
  
  
  CONCLUSIONS
  The unilateral septal flap pedicle by anterior ethmoidal artery may be used for small and medium perforations with a pedicle smaller than 1 cm posterior to the axilla.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanova 90, 08025, Barcelona, Spain. jgras@santpau.cat.
authors.forename: Juan R
authors.initials: JR
authors.lastname: Gras-Cabrerizo
authors.affiliation: Department of Radiology, Hospital Universitario de Alicante, Universidad Miguel Hernandez, Pintor Baeza 12, 03010, Alicante, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: García-Garrigós
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital General de Cataluña, Universitat Autònoma de Barcelona, Pedro I Pons, 1, 08915, Sant Cugat del Vallès, Spain.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Ademá-Alcover
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Complexo Hospitalario Universitario A Coruña, As Xubias, 84, 15006, A Coruña, Spain.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Sarandeses-Garcia
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanova 90, 08025, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Martel-Martin
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanova 90, 08025, Barcelona, Spain.
authors.forename: Joan R
authors.initials: JR
authors.lastname: Montserrat-Gili
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital Universitario de Alicante, Universidad Miguel Hernandez, Mas Casanova 90, 08025, Alicante, Spain.
authors.forename: Juan R
authors.initials: JR
authors.lastname: Gras-Albert
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanova 90, 08025, Barcelona, Spain.
authors.forename: Humbert
authors.initials: H
authors.lastname: Massegur-Solench
mesh_terms: D000328:Adult; D002102:Cadaver; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods; D005005:Ethmoid Sinus / Q000098:blood supply / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D009296:Nasal Cavity / Q000000981:diagnostic imaging*; D061270:Nasal Septal Perforation / Q000000981:diagnostic imaging / Q000601:surgery*; D009300:Nasal Septum / Q000098:blood supply / Q000000981:diagnostic imaging*; D009880:Ophthalmic Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000033:anatomy & histology / Q000000981:diagnostic imaging
keywords: Castelnuovo; Endoscopic approach; Ethmoidal artery; Flap; Septal perforation