Direct Endonasal Approach with Partial Upper Posterior Septectomy. A "Rescue Flap" Technique Modification.
ObjectiveReport a modification of the "rescue flap" technique using a direct endonasal approach with a partial superior septectomy for approaching pituitary tumors developed in our institution.DesignProspective study.SettingHospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León.Main Outcome MeasuresSince April 2015, we have performed 19 cases employing a direct endonasal approach with partial superior septectomy. Results and a technical note are described below.ResultsNineteen patients were included in this report. Six patients presented transoperatory cerebrospinal fluid (CSF) leak, so a nasoseptal rescue flap was harvested. No patients developed postoperative CSF leak in this group. Two patients were submitted to a second surgical procedure. Nasoseptal flap was harvested without complications. In both patients, the size of the flap was enough to cover the dural defect and avoid CSF leak.ConclusionDirect endonasal approach with a partial posterior septectomy allows enough exposition of the sphenoidal sinus while preserving the nasoseptal septum with the possibility of a successful rescue flap when needed.
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Arturo
A
Sotomayor-González
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Armando José
AJ
Díaz-Martínez
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Ramón
R
Radillo-Gil
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Everardo
E
García-Estrada
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Jesús Alberto
JA
Morales-Gómez
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Isaac Jair
IJ
Palacios-Ortiz
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Samuel
S
Pérez-Cárdenas
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Mauricio
M
Arteaga-Treviño
Servicio de Neurocirugía y Terapia Endovascular Neurológica, Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Ángel Martínez-Ponce
ÁM
De León
endoscopy; partial septectomy; pituitary surgery; rescue flap