The Magnetic Resonance Imaging Appearance of Endoscopic Endonasal Skull Base Defect Reconstruction Using Free Mucosal Graft

World Neurosurgery
Christine S KimCarlos D Pinheiro-Neto

Abstract

At our institution, skull base reconstruction using a free mucosal graft from the nasal cavity floor has been the standardized technique after pituitary adenoma resection via transsellar approach. In this study, the expected appearance of the reconstruction on postoperative magnetic resonance imaging (MRI) scans is described and its integrity and impact on the sinonasal cavity are assessed. Fifty patients were selected, and their electronic medical records were reviewed for postoperative course, Sino-Nasal Outcome Test-22 (SNOT-22) scores, and nasal endoscopy reports. A total of 116 postoperative MRI scans were available to evaluate 1) the appearance and thickness of the graft, 2) the enhancement of the graft, and 3) the T2 signal in sphenoid sinus as a potential indication for inflammatory disease. There was no significant change in the thickness of the graft over time. Except for the 7 scans that were obtained without intravenous contrast, all scans showed enhancement of the graft. About half of the patients showed persistent T2 hyperintense signal at 12 and 24 months. However, this finding was not clinically significant, because postoperative SNOT-22 scores showed minimal sinonasal impact. Postoperative MRI surveillance scan...Continue Reading

References

Feb 14, 2009·AJNR. American Journal of Neuroradiology·M D KangW Rothfus
Sep 9, 2010·Head & Neck·John R de AlmeidaAllan D Vescan
Apr 27, 2011·The Laryngoscope·Carlos M Rivera-SerranoAdam Zanation
Jul 10, 2012·American Journal of Otolaryngology·Reza VaezeafsharJustin H Turner
Aug 3, 2013·Pituitary·Alessandro PaluzziPaul A Gardner
Jan 18, 2014·Journal of Neurological Surgery. Part B, Skull Base·Adam S DecondeJeffrey D Suh
Jan 27, 2015·Clinical Neurology and Neurosurgery·Ahmed J AwadManish K Aghi
Aug 1, 2015·Journal of Neurological Surgery. Part B, Skull Base·Chris Sanders-TaylorPhillip V Theodosopoulos
Mar 10, 2016·American Journal of Otolaryngology·Cristobal LangdonIsam Alobid

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Citations

Jan 1, 2021·Acta otorrinolaringológica española·Ramón Moreno-LunaSerafín Sánchez-Gómez
Jul 24, 2021·Acta Otorrinolaringologica Española·Ramón Moreno-LunaSerafín Sánchez-Gómez

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