Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Indian Journal of Otolaryngology and Head & Neck Surgery
Published in: Indian Journal of Otolaryngology and Head & Neck Surgery 3/2019

01-11-2019 | Other Articles

Sphenoid Mucocele: A Complication of Skull Base Reconstruction with Nasoseptal Flap—A Critical Review and Our Experience

Authors: T. N. Janakiram, Abhilasha Karunasagar

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Special Issue 3/2019

Login to get access

Abstract

The evolution of expanded endoscopic skull base surgery has enabled development of minimally invasive approaches for resection of large skull base tumors with the nasoseptal flap proving to be an indispensable tool in skull base reconstruction. We here present our experience of sphenoid mucocele development after skull base reconstruction with the nasoseptal flap along with a comprehensive review of the limited literature on the same. With the expanding scope of endoscopic skull base surgery, the nasoseptal flap is increasingly being used for reconstruction. Despite adherence to standard recommendations and use of meticulous technique during flap placement, the potential risk of mucocele formation under the flap should always be borne in mind. In our experience, displacement of the flap pedicle could lead to ostial obstruction and mucocele formation. Hence, in addition to meticulous technique, a close follow up of such patients via nasal endoscopy or imaging is important to further our knowledge and understanding of the long-term effects and complications of this flap.
Literature
1.
Zanation AM, Carrau RL, Snyderman CH et al (2009) Nasoseptal flap reconstruction of high flow intraoperative cerebral spinal fluid leaks during endoscopic skull base surgery. Am J Rhinol Allergy 23:518–521PubMed
2.
Shah RN, Surowitz JB, Patel MR et al (2009) Endoscopic pedicled nasoseptal flap reconstruction for pediatric skull base defects. Laryngoscope 119:1067–1075PubMed
3.
Caicedo-Granados E, Carrau R, Snyderman CH et al (2010) Reverse rotation flap for reconstruction of donor site after vascular pedicled nasoseptal flap in skull base surgery. Laryngoscope 120:1550PubMed
4.
Bleier BS, Wang EW, Vandergrift WA II, Schlosser RJ (2011) Mucocele rate after endoscopic skull base reconstruction using vascularized pedicled flaps. Am J Rhinol Allergy 25:186–187PubMed
5.
Vaezeafshar R, Hwang PH, Harsh G, Turner JH (2012) Mucocele formation under pedicled nasoseptal flap. Am J Otolaryngol 33:634–636PubMed
6.
Eloy JA, Fatterpekar GM, Bederson JB, Shohet MR (2007) Intracranial mucocele: an unusual complication of cerebrospinal fluid leakage repair with middle turbinate mucosal graft. Otolaryngol Head Neck Surg 137:350–352PubMed
7.
Wang L, Kim J, Heilman CB (1999) Intracranial mucocele as a complication of endoscopic repair of cerebrospinal fluid rhinorrhea: case report. Neurosurgery 45:1243–1245PubMed
8.
Kosling S, Hinter M, Brandt S, Schulz T, Bloching M (2004) Mucoceles of the sphenoid sinus. Eur J Radiol 51:1–5PubMed
9.
Hantzakos AG, Dowley AL, Yung MW (2003) Sphenoid sinus mucocele: late complication of sphenoidotomy. J Laryngol Otol 117:561–563PubMed
10.
Delfini R, Missori P, Iannetti G, Ciappetta P, Cantore G (1993) Mucoceles of the paranasal sinuses with intracranial and intraorbital extension: report of 28 cases. Neurosurgery 32:901–906PubMed
11.
Kim YS, Kim K, Lee JG et al (2011) Paranasal sinus mucoceles with ophthalmologic manifestations: a 17-year review of 96 cases. Am J Rhinol Allergy 25:272–275PubMed
12.
Daniilidis J, Nikolaou A, Kondopoulos V (1993) An unusual case of sphenoid sinus mucocele with severe intracranial extension. Rhinology 31:135–137PubMed
13.
Rombaux P, Bertrand B, Eloy P et al (2000) Endoscopic endonasal surgery for paranasal sinus mucoceles. Acta Otorhinolaryngol Belg 54:115–122PubMed
14.
Rejab E, Said H, Saim L, Thim L (1991) Sphenoid sinus mucocele: a possible late com- plication of radiotherapy to the head and neck. J Laryngol Otol 105:959–960PubMed
15.
Lund VJ, Henderson B, Song Y (1993) Involvement of cytokines and vascular adhesion receptors in the pathology of fronto-ethmoidal mucocoeles. Acta Otolaryngol 113:540–546PubMed
16.
Herman P, Lot G, Guichard JP et al (1998) Mucocele of the sphenoid sinus: a late complication of transsphenoidal pituitary surgery. Ann Otol Rhinol Laryngol 107:765–768PubMed
17.
Di Rocco F, Couloigner V, Dastoli P et al (2010) Treatment of anterior skull base defects by a transnasal endoscopic approach in children. J Neurosurg Pediatr 6:459–463PubMed
18.
Giordano M, Gerganov VM, Draf W et al (2012) Sphenoid sinus pyocele after transsphenoidal approach for pituitary adenoma. Pituitary 15:188–192PubMed
19.
Lu YJ, Chang CN, Pai PC et al (2009) Isolated sphenoid sinusitis or mucocele: a potential complication of endonasal transsphenoidal surgery. J Neurooncol 91:63–67PubMed
20.
Kessler L, Legaludec V, Dietemann JL et al (1999) Sphenoidal sinus mucocele after transsphenoidal surgery for acromegaly. Neurosurg Rev 22:222–225PubMed
21.
Hadad G, Bassagasteguy L, Carrau RL et al (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116:1882–1886PubMed
22.
Eloy JA, Kalyoussef E, Choudhry OJ et al (2012) Salvage endoscopic nasoseptal flap repair of persistent cerebrospinal fluid leak after open skull base surgery. Am J Otolaryngol 33:735–740PubMed
23.
Eloy JA, Patel SK, Shukla PA et al (2013) Triple-layer reconstruction technique for large cribriform defects after endoscopic endonasal resection of anterior skull base tumors. Int Forum Allergy Rhinol 3:204–211PubMed
24.
Kassam AB, Thomas A, Carrau RL et al (2008) Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap. Neurosurgery 63:ONS44–ONS52PubMed
25.
Snyderman CH, Kassam AB, Carrau R, Mintz A (2007) Endoscopic reconstruction of cranial base defects following endonasal skull base surgery. Skull Base 17:73–78PubMedPubMedCentral
26.
Liu JK, Schmidt RF, Choudhry OJ et al (2012) Surgical nuances for nasoseptal flap reconstruction of cranial base defects with high-flow cerebrospinal fluid leaks after endoscopic skull base surgery. Neurosurg Focus 32:E7PubMed
27.
Schmidt RF, Choudhry OJ, Raviv J et al (2012) Surgical nuances for the endoscopic endonasal transpterygoid approach to lateral sphenoid sinus encephaloceles. Neurosurg Focus 32:E5PubMed
28.
Eloy JA, Choudhry OJ, Friedel ME et al (2012) Endoscopic nasoseptal flap repair of skull base defects: is addition of a dural sealant necessary? Otolaryngol Head Neck Surg 147:161–166PubMed
29.
Eloy JA, Choudhry OJ, Shukla PA et al (2012) Nasoseptal flap repair after endoscopic transsellar versus expanded endonasal approaches: is there an increased risk of postoperative cerebrospinal fluid leak? Laryngoscope 122:1219–1225PubMed
30.
Eloy JA, Kuperan AB, Choudhry OJ et al (2012) Efficacy of the pedicled nasoseptal flap without cerebrospinal fluid (CSF) diversion for repair of skull base defects: incidence of postoperative CSF leaks. Int Forum Allergy Rhinol 2:397–401PubMed
31.
32.
Husain Q, Sanghvi S, Kovalerchik O, Shukla PA, Choudhry OJ, Liu JK et al (2013) Assessment of mucocele formation after endoscopic nasoseptal flap reconstruction of skull base defects. Allergy Rhinol 4:e27–e31
33.
Nyquist GG, Anand VK, Singh A, Schwartz TH (2010) Janus flap: bilateral nasoseptal flaps for anterior skull base reconstruction. Otolaryngol Head Neck Surg 142:327–331PubMed
34.
35.
Soudry E, Psaltis AJ, Lee KH, Vaezafshar R, Nayak JV, Hwang PH (2015) Complications associated with the pedicled nasoseptal flap for skull base reconstruction. Laryngoscope 125(01):80–85PubMed
36.
Dolci RL, Miyake MM, Tateno DA, Cancado NA, Campos CA, Santos AR et al (2017) Postoperative otorhinolaryngologic complications in transnasal endoscopic surgery to access the skull base. Braz J Otorhinolaryngol 83:349–355PubMed
37.
38.
Friedman A, Batra PS, Fakhri S et al (2005) Isolated sphenoid sinus disease: etiology and management. Otolaryngol Head Neck Surg 133(544–50):2
39.
Moriyama H, Hesaka H, Tachibana T et al (1992) Mucoceles of ethmoid and sphenoid sinus with visual disturbance. Arch Otolaryngol Head Neck Surg 118:142–146PubMed
40.
Lee LA, Huang CC, Lee TJ (2004) Prolonged visual disturbance secondary to isolated sphenoid sinus disease. Laryngoscope 114:9
41.
Sethi DS, Lau DP, Chan C (1997) Sphenoid sinus mucocoele presenting with isolated oculomotor nerve palsy. J Laryngol Otol 111:471–473PubMed
42.
Hejazi N, Witzmann A, Hassler W (2001) Occular manifestations of sphenoid mucoceles: clinical features and neurosurgical management of three cases and a review of the literature. Surg Neurol 56:338–343PubMed
43.
Kennedy DW, Josephson JS, Zinreich SJ et al (1989) Endoscopic sinus surgery for mucoceles: a viable alternative. Laryngoscope 99:885–895PubMed
44.
Giovannetti F, Filiaci F, Ramieri V et al (2008) Isolated sphenoid sinus mucocele, etiology and management. J Craniofac Surg 19:1381–1384PubMed
45.
Har-El G (2001) Endoscopic management of 108 sinus mucoceles. Laryngoscope 111:2131–2134PubMed
46.
Lund VJ (1998) Endoscopic management of paranasal sinus mucoceles. J Laryngol Otol 112:36–40PubMed
47.
Benkhatar H, Khettab I, Sultanik P, Laccourreye O, Bonfils P (2018) Mucocele development after endoscopic sinus surgery for nasal polyposis: a long-term analysis. Ear Nose Throat J 97(9):284–294PubMed
Metadata
Title
Sphenoid Mucocele: A Complication of Skull Base Reconstruction with Nasoseptal Flap—A Critical Review and Our Experience
Authors
T. N. Janakiram
Abhilasha Karunasagar
Publication date
01-11-2019
Publisher
Springer India
Published in
Indian Journal of Otolaryngology and Head & Neck Surgery / Issue Special Issue 3/2019
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-019-01713-y

Other articles of this Special Issue 3/2019

Indian Journal of Otolaryngology and Head & Neck Surgery 3/2019 Go to the issue

Original Article

A Prospective Study to Compare the Efficacy of Powered Turbinectomy Versus Submucous Resection in the Surgical Management of Inferior Turbinate Hypertrophy

Clinical Report

An Unusual and Neglected Foreign Body in the Ethmoid Sinus

Original Article

Does Endoscopic Sinus Surgery (ESS) Retrieve Mucociliary Clearance of Maxillary Sinus: Prospective Study at a Tertiary Care Hospital

Clinical Report

Nasal Framework Reconstruction in Patient with Eosinophilic Angiocentric Fibrosis

Original Article

Evaluation of Role of Mitomycin C in the Cases of Nasolacrimal Duct Blockage Undergoing Endoscopic Dacryocystorhinostomy

Original Article

Evaluation of Mucociliary Activity in Maxillary Antra in Patients with Squamous Cell Carcinoma of Buccal Mucosa Undergoing Post Operative Radiotherapy