■在这项具有临床相关性的放射解剖学研究中,我们研究了“延长鼻底粘膜”(ENFM)游离移植物的变异,单纯鼻底粘膜(PuNFM)游离移植。本研究的目的是评估PuNFM提供的覆盖表面积,研究PuNFM在内窥镜经鼻入路(EEA)经鞍术后缺损重建中的充分性,并将这种重建技术与当前的鞍区重建方法进行比较和评估。
■对五个尸体标本进行解剖。双侧收获PuNFM,并计算提供的重建面积。分析了通过EEA切除的25例垂体腺瘤的连续病例,以估计经鞍式EEA后的鞍区缺损表面积(SDSA),并计算双侧PuNFM面积。
■尸体SDSA中位数为4.77cm2,左侧和右侧PuNFM中位数面积分别为5.09和5.19cm2。临床上,SDSA中位数为5.36cm2,放射总PuNFM表面积为5.46cm2,改良的Knosp分级>2级肿瘤的SDSA大于Knosp分级<2级肿瘤的SDSA.事实证明,PuNFM移植物最有效地覆盖改良的Knosp<2肿瘤缺陷。
■PuNFM代表了ENFM游离移植鞍区缺损重建技术的一种变体,该技术提供了足够的表面积来重建与垂体腺瘤的经鞍区EAA相关的大多数鞍区缺损。这种技术可能会对鼻窦功能和生活质量产生积极影响。需要未来的前瞻性临床研究来验证这些发现。
UNASSIGNED: In this radioanatomical study with clinical correlate, we study a variation of the \'extended nasal floor mucosa\' (ENFM) free-graft, the purely nasal floor mucosa (PuNFM) free-graft. The objectives of this study are to evaluate the coverage surface area provided by the PuNFM, study the adequacy of the PuNFM in the reconstruction of endoscopic endonasal approach (EEA) transsellar postoperative defects and compare and evaluate this reconstructive technique with current sellar region reconstruction practices.
UNASSIGNED: Dissections were performed on five cadaveric specimens. PuNFM were harvested bilaterally and the area provided for reconstruction was calculated. Twenty-five consecutive cases of pituitary adenomas resected through an EEA were analyzed to estimate the sellar defect surface area (SDSA) after a transsellar EEA and calculate the area of PuNFM bilaterally.
UNASSIGNED: The median cadaveric SDSA was 4.77 cm2, with a median left and right side PuNFM area of 5.09 and 5.19 cm2, respectively. Clinically, the median SDSA was 5.36 cm2, and the total radiological PuNFM surface area was 5.46 cm2, with modified Knosp grade >2 tumors having larger SDSA than that of Knosp grade <2 tumors. The PuNFM graft proved to be most effective for covering modified Knosp <2 tumor defects.
UNASSIGNED: The PuNFM represents a variation of the ENFM free-graft sellar defect reconstruction technique that provides sufficient surface area to reconstruct the majority of the sellar defects related to transsellar EAA for pituitary adenomas. This technique may positively impact sinonasal function and quality of life. Future prospective clinical studies are needed to verify these findings.