Radioanatomical analysis for precise harvesting of the pedicled nasoseptal flap in anterior skull base reconstruction during craniofacial surgery

To evaluate the role of the vascularized nasoseptal flap (VNSF) and septal flip flap (SFF) in anterior skull base (ASB) reconstruction of craniofacial therapy by studying the radioanatomy of VNSF, SFF and ASB reconstruction data on adult Computed Tomography (CT) multiplanar reconstruction. The length, width and area of VNSF, SFF, and ASB defects were measured by Computed Tomography CT in 40 adults, and then the above date were statistically analyzed to confirm whether VNSF and SFF can be used to cover the ASB defect region produced after surgery. The area of VNSF far exceeded that of ASB defect (10.21 ± 1.97 cm 2 ), and the anterior and posterior widths, as well as the upper and lower lengths of VNSF were at least 8.4 mm longer than the corresponding width and length of ASB defect to be reconstructed. The VNSF containing vascular pedicle had a total length exceed that required for ASB reconstruction via the anterior wall of the sphenoid sinus (SS) by at least 17.6 mm, but a mean length that was 7.02 ± 8.71 mm less than that required for transsphenoidal reconstruction of ASB. The area of SFF far exceeded that of the ASB defect (8.93 ± 1.49 cm 2 ). The anterior and posterior widths, as well as the lower length of SFF all exceeded the corresponding width and length of the ASB defect to be reconstructed by at least 8.4 mm, and the upper length exceeded the ASB defect length by at least 1.5 mm. The independent sample t test showed no difference between sexes. Pearson correlation analysis showed no age difference except for the difference between SFF anterior width and ASB anterior width ( P = 0.016). VNSF can reconstruct the defect of ASB through the anterior wall of the SS. With the assistance of SS packing and other methods, VNSF can transsphenoidally reconstruct the defect of the ASB, and SFF can reconstruct the defect of the ASB.