关键词: 鼻中隔带蒂黏膜瓣, 脑脊液鼻漏, 颅底缺损, 放射治疗

Abstract:

Objective   To explore the impaction and significance of radiation therapy on repair of skull base defect with nasal septum mucosa flap with pedicle in rabbit models. Methods   Ten fresh white rabbit bodies served for the anatomy research of blood supply of nasal septum mucosa flap. Twenty  New Zealand white rabbits were induced into models of skull base defect and cerebrospinal fluid rhinorrhea. Nasal septum mucosa flap with pedicle was employed to reconstruct the defect and repair the leakage.  Seven  days and 10 days after the operation, wound healing and leakage were observed by nasal endoscopy. Twenty-one  days after the operation, 10 rabbits which accepted the surgical treatment as the experimental group were randomly drew to get radiation therapy, the other 10 as the control group.  One day and 14 days after the radiation therapy, repair area of the experiment and the control groups were respectively observed by nasal endoscopy. Results   Seven  blood supplies of the nasal septum mucosa flap come from behind and below the nasal septum, 2 blood supplies come from behind the nasal septum 1cm away, and 1 did not show obvious blood supply. Twenty  rabbits models of skull base defect and cerebrospinal fluid rhinorrhea and the nasal septum mucosa flap with pedicle was employed to reconstruct the defect and repair the leakage were successfully established and survived without any complication as continuous rhinorrhea of cerebrospinal fluid, local tissue eminence and neurological function defect.Ten  rabbits of the experiment group which accepted radiation therapy and 10 rabbits of the control group were all survived, but the speed of wound healing of the rabbits of the experiment group was fairly slower. Conclusion   Repair of skull base defect with the nasal septum mucosa flap with pedicle in rabbit models is feasible, and radiation therapy can delay the speed of healing of the nasal septum mucosa flap with pedicle.

Key words: Skull base defect, Pedicle nasal septum mucosa flap, Radiation therapy, Cerebrospinal fluid rhinorrhea