目的评价颊脂肪垫在内镜下颅底缺损重建中的有效性和安全性。设计描述性解剖学研究,并提供说明性案例介绍。对12个新鲜的人尸体标本进行了解剖研究,并注射了动脉(24侧)。颈内动脉通过内镜下经翼状骨入路暴露于冠状平面。带蒂的颊脂肪垫用于重建。参与者:12个人尸体头部标本;一名患者使用拟议的技术进行手术。主要结局指标:颊脂肪垫皮瓣靠近缺损,襟翼的顺应性,收获过程的舒适性和安全性,以及与Hadad-Bassagasteguy鼻中隔皮瓣的兼容性.结果:使用前经上颌走廊进行收获手术。带蒂的颊脂肪垫皮瓣可用于包裹蝶窦或覆盖从海绵体到咽旁段的颈内动脉。结论颊脂肪垫可以通过相同的方法安全地采集,无需外切口,并且足够顺应性以符合颅底缺损。建议的带蒂皮瓣可以在中央颅底重建中替代腹部游离脂肪。颊脂肪垫的体积可以消除蝶窦或咽旁间隙。
Objectives To evaluate the efficacy and safety of using a buccal fat pad for endoscopic skull base defect reconstruction. Design Descriptive anatomical
study with an illustrative case presentation. Setting Anatomical
study was performed on 12 fresh human cadaver specimens with injected arteries (24 sides). Internal carotid artery was exposed in the coronal plane via the endoscopic transpterygoid approach. The pedicled buccal fat pad was used for reconstruction. Participants: 12 human cadaver head specimens; one patient operated using the proposed technique. Main outcome measures: Proximity of the buccal fat pad flap to the defect, compliance of the flap, comfort and safety of harvesting procedure, and compatibility with the Hadad-Bassagasteguy nasoseptal flap. Results: Harvesting procedure was performed using anterior transmaxillary corridor. The pedicled buccal fat pad flap can be used to pack the sphenoid sinus or cover the internal carotid artery from cavernous to upper parapharyngeal segment. Conclusion The buccal fat pad can be safely harvested through the same approach without external incisions and is compliant enough to conform to the skull base defect. The proposed pedicled flap can replace free abdominal fat in central skull base reconstruction. The volume of the buccal fat pad allows obliteration of the sphenoid sinus or upper parapharyngeal space.