Nasoseptal flap using septal cartilage bests Fascia Lata with fat in CSF rhinorrhoea cases

The study is published in the Indian Journal of Otolaryngology and Head & Neck Surgery.

The nasoseptal flap is a versatile and reliable local reconstructive technique for ventral base traumatic defects, with a 100% CSF leak repair rate in this series. Traumatic injury to the ventral skull base carries a high risk of developing cerebrospinal fluid (CSF) leak.

Shrinivas S. Chavan and colleagues from the Department of Otorhinolaryngology, Sir J.J. Group of Hospitals, Grant Government Medical College, Mumbai, India carried out the study with the objective to evaluate the surgical outcome between free nasoseptal mucoperichondrial flap using septal cartilage vs fascia lata using fat in terms of morbidity, hospital stay and postoperative complications.

The authors conducted a retrospective comparative study including a total of 127 patients, all of whom were diagnosed with CSF leak and who underwent repair of anterior skull base defect using free nasoseptal mucoperichondrial graft with septal cartilage in 73 cases compared with fascia lata with fat in 54 cases over the time frame of 5 years.

The following findings were observed-

7. The success rate with free nasoseptal flap with septal cartilage was 97.3% and that with fascia lata with fat was 96.3%.
8. There was a significant association between mean hospital stay and the technique of CSF repair (unpaired t test, p −0.02).
9. In the study the complications following the repair with free nasoseptal flap with septal cartilage was significantly less (p < 0.05, chi square test).

Hence, this led the authors to conclude that "patients treated with free nasoseptal flap using septal cartilage has less hospital stay, less post-operative morbidity in the form of pain, movement and dependence for cleaning and dressing in comparison to fascia lata using fat."