Usefulness of endonasal flaps and grafts in skull base surgery. Consensus document

• Published in: Acta otorrinolaringológica española (English)
• Main Authors: Moreno-Luna, Ramón, Mariño Sánchez, Franklin, Kaen, Ariel, Gras Cabrerizo, Juan Ramón, Mata Castro, Nieves, González García, Jaime, Villacampa Aubá, José Miguel, Cárdenas Ruiz-Valdepeñas, Eugenio, Monjas Cánovas, Irene, Del Cuvillo Bernal, Alfonso, García Piñero, Alfonso, Maza Solano, Juan Manuel, Fernández de Liesa, Rafael, Sánchez-Gómez, Serafín, Alobid, Isam
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01.09.2022
• Subjects: Delphi Method; Mucoplasty; Reconstrucción de base de cráneo; Nasoseptal Flap; Método Delphi; Cirugía endoscópica endonasal; Endonasal grafts; Injertos endonasales; Cerebrospinal fluid leaks; Mucoplastia; Documento de consenso; Fístula de líquido cefalorraquídeo; Colgajo nasoseptal; Consensus document; Skull base reconstruction; Endoscopic endonasal approach
• ISSN: 2173-5735
• DOI: 10.1016/j.otorri.2021.02.005

Skull base reconstruction is one of the greatest challenges extended endonasal endoscopic surgery. Many grafts and flaps from the endonasal fossa have been demonstrated to be useful in the control of complications such a cerebrospinal fluid leaks. Review and analysis of these resources are necessary in skull base recontruction to improve outcomes. The target is to create a consensus document on the use of different endonasal flaps and grafts in the skull base surgery. Literature review of the most relevant free grafts and vascularized flaps from the endonasal fossa. Analysis using the Delphi method on the use of the different endonasal resources for endoscopic repair of skull base defects. We obtained two results: 1) A selection of the most representative flaps and grafts from the endonasal fossa, describing origin, surface and indications, based on a literature review. 2) A consensus document, using Delphi methodology, with general considerations (2), recommendations (10) and limitations (6) of the different endonasal flaps and grafts. We present the first consensus document in the field of extended endonasal endoscopic surgery using the Delphi method as a working tool. We highlight the usefulness of the nasoseptal flap together with other endonasal flaps and grafts for skull base reconstruction.