Abstract：
The nasal skull base is located into the deep position of nasal cavity and closely related to important nerves and vessels. The complete removal of tumors in this area poses a complex surgical challenge.In order to investigate the clinical efficacy of utilizing free middle turbinate mucosa (FMT), fascia lata, and pedicled nasal septum flap (known as the Hadad-Bassagasteguy flap, HBF) for the treatment of cerebrospinal fluid (CSF) rhinorrhea, a retrospective analysis was conducted on clinical data from 65 patients who underwent skull base reconstruction following endoscopic resection of nasal-skull base tumors. The selection of the repair material was based on the size and location of the defect. For defects less than 1.5 cm (n = 24), FMT was chosen, while for defects greater than or equal to 1.5 cm (n = 16), HBF was preferred. In cases where HBF was not available or not suitable (specifically, when the defect was located on the posterior wall of the frontal sinus), fascia lata was selected (n = 25). The repair outcomes of all 65 patients were summarized, and subsequently, a comparison was made between the use of fascia lata and HBF. The overall success rate for one-time repairs was 93.8 %. Specifically, the success rates for repairs using FMT, fascia lata, and HBF were 91.7 %, 96.0 %, and 93.8 %, respectively. Throughout the follow-up period, there were 2 cases of postoperative CSF leakage out of 24 patients who underwent FMT reconstruction, 1 case out of 25 patients who underwent fascia lata reconstruction, and 1 case out of 16 patients who underwent HBF reconstruction. The occurrence of postoperative complications, such as intracranial infection, lung infection, and epistaxis, was observed in both the fascia lata group and the HBF group. However, there were no statistically significant differences between the two groups. The transnasal endoscopic reconstruction of skull base defect using HBF, fascia lata, and FMT demonstrated satisfactory repair effects in managing CSF rhinorrhea. Generally, FMT has been found to be a dependable repair material for small defects measuring less than 1.5 cm, while in the case of larger defects equal to or exceeding 1.5 cm, both HBF and fascia lata can be utilized with comparable repair outcomes. The selection of fascia lata becomes a viable option when HBF is unavailable or not suitable.
摘要：
鼻颅底位于鼻腔深处，与重要的神经血管密切相关。该区域肿瘤的完全切除提出了复杂的手术挑战。为了探讨游离中鼻甲黏膜(FMT)的临床疗效,筋膜，和带蒂鼻中隔皮瓣（称为Hadad-Bassagasteguy皮瓣，HBF）用于治疗脑脊液（CSF）鼻漏，我们对65例鼻-颅底肿瘤内镜切除后颅底重建患者的临床资料进行了回顾性分析.修复材料的选择基于缺陷的大小和位置。对于小于1.5cm（n=24）的缺陷，FMT被选中，而对于大于或等于1.5厘米（n=16）的缺陷，HBF是首选。在HBF不可用或不适合的情况下(特别是，当缺损位于额窦后壁时），选择阔筋膜(n=25)。对所有65例患者的修复结果进行总结，随后,比较了阔筋膜和HBF的使用。一次性修理的总体成功率为93.8%。具体来说,使用FMT进行维修的成功率，筋膜，HBF为91.7%，96.0%,和93.8%，分别。在整个随访期间，24例FMT重建患者术后脑脊液漏2例,25例患者中1例进行阔筋膜重建,16例接受HBF重建的患者中有1例。术后并发症的发生,例如颅内感染，肺部感染,还有鼻出血,在阔筋膜组和HBF组中都观察到。然而,两组间差异无统计学意义。鼻内镜下应用HBF重建颅底缺损,筋膜，FMT在治疗脑脊液鼻漏方面表现出令人满意的修复效果。一般来说,FMT已被发现是一种可靠的修补材料，用于测量小于1.5厘米的小缺陷，而在较大的缺陷等于或超过1.5厘米的情况下，HBF和阔筋膜均可用于具有可比性的修复结果。当HBF不可用或不适合时，筋膜的选择成为可行的选择。
