Mucosal-sparing posterior septectomy for endoscopic endonasal approach to the craniocervical junction

Jean Anderson Eloy, Alejandro Vazquez, Leila J. Mady, Chirag R. Patel, Ira M. Goldstein, James K. Liu

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Recent technological advances and developments in surgical technique have made the craniocervical junction (CCJ) accessible through the transnasal surgical corridor. Endoscopic endonasal transclival and transodontoid approaches have been previously described in the literature. Traditionally, these approaches entail a posterior bony and mucosal septectomy. This posterior bony and mucosal septectomy can compromise the integrity of the posterior septum and damage the vascularized pedicled nasoseptal flap (PNSF), a robust reconstructive option. With the possibility of an intraoperative cerebrospinal fluid (CSF) leak and the reported success of the PNSF for repair of these defects, preserving the integrity of the PNSF is beneficial during the endoscopic endonasal approach to the CCJ. Here, we present a new variation which preserves the mucosal integrity of the posterior nasal septum and PNSF. This mucosal-sparing variation of the traditional endoscopic endonasal transclival and transodontoid approaches allows for the preservation of posterior mucosal nasoseptal integrity, and salvages a reconstructive option for future usage. This is accomplished at no expense to visualization, surgical access, or maneuverability.

Original languageEnglish (US)
Pages (from-to)342-346
Number of pages5
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume36
Issue number3
DOIs
StatePublished - May 1 2015

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

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