Author: Krane, Natalie A; Troob, Scott H; Wax, Mark K
Title: Combined endoscopic and transcervical approach for free flap reconstruction of nasopharyngeal and clival defects: A case report. Cord-id: 6v2s631a Document date: 2019_1_1
ID: 6v2s631a
Snippet: We report a case during which a new method of reconstruction for a nasopharyngeal and skull base defect was successfully performed. A 45-year-old female with granulomatosis with polyangiitis presented with computed tomography (CT) findings demonstrative of chronic clival and cervical spine osteomyelitis secondary to nasopharyngeal destruction. The posterior nasopharyngeal defect, evident as a wide area of mucosal erosion exposing the clivus centrally, was successfully reconstructed with an anter
Document: We report a case during which a new method of reconstruction for a nasopharyngeal and skull base defect was successfully performed. A 45-year-old female with granulomatosis with polyangiitis presented with computed tomography (CT) findings demonstrative of chronic clival and cervical spine osteomyelitis secondary to nasopharyngeal destruction. The posterior nasopharyngeal defect, evident as a wide area of mucosal erosion exposing the clivus centrally, was successfully reconstructed with an anterior serratus muscle-free tissue transfer via both transcervical and endoscopic transnasal approaches utilizing a laparoscopic fixation device, a previously unreported method for free flap inset, to secure the free flap. The patient tolerated this well and no major complications were encountered. At 2-year follow-up, the patient was without signs of cerebrospinal fluid leak or sequelae of infectious complications, including meningitis and osteomyelitis. A combined transcervical and endoscopic transnasal approach using a laparoscopic fixation device for free flap inset can be an effective method to reconstruct posterior nasopharyngeal defects in those patients whom local reconstructive options are not available.
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