2025 Poster Presentations
P255: PEDICLED NASOSEPTAL FLAP AFTER ENDOSCOPIC ENDONASAL RESECTION OF SKULL BASE TUMORS: A COMPARATIVE META-ANALYSIS WITH OTHER MODALITIES OF RECONSTRUCTION
Adriano Lino-Filho1; Rodrigo Cavalcante, PhD1; Mateus Fernandes1; Otávio Teixeira1; Júlia Gomes2; Weder Borges-Júnior1; Leandro Camargo, PhD3; 1Division of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil; 2Department of Otorhinolaryngology, General Hospital of Goiânia, Goiás, Brazil.; 3Division of Otorhinolaryngology, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil
Introduction: Endoscopic endonasal surgery for skull base tumors has advanced significantly, but postoperative cerebrospinal fluid (CSF) leaks remain a majorsignificant concern. The introduction ofIntroducing the vascularized pedicled nasoseptal flap (PNSF) has markedly reduced CSF leak rates, though outcomes remain variable across different studies. This systematic review and meta-analysis aimed to compare the efficacy of vascularized versus non-vascularized reconstruction techniques in these procedures.
Material and Methods: Three databases (PubMed, Cochrane, and Embase) were systematically searched to identify studies comparing CSF leak raterates between PNSF and non-vascularized techniques for reconstruction after endoscopic endonasal skull base surgeries. It was designed in accordance with theIt was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Statistical analysis was performed using Review Manager, with heterogeneity evaluated via the I² statistic.
Results: The postoperative CSF leak ratio was significantly lower in the group that underwent reconstruction with PNSF compared to all the other grouped methods, respectively, 3.4% and 5.6% (OR 0.48; 95% CI 0.34-0.66; p<0.00001; I2=54%). However, patients who undergo vascularized PNSF reconstruction are more likely to experience postoperative olfactory dysfunction compared to those who do not undergo this technique.
Conclusions: Our results suggest that the use ofusing the PNSF is associated with a lower incidence of postoperative CSF leaks compared tothan other reconstruction techniques in endoscopic skull base surgeries.