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After a nasoseptal flap (NSF) is performed for skull base reconstruction, patients often have significant crusting along the exposed anterior cartilaginous septum and delayed remucosalization. Placing a free mucosal graft (FMG) on the NSF donor site cartilage can help improve postoperative sinonasal symptoms. In this video, we demonstrate the use of a septal stapler to secure a septal FMG to the NSF donor site following endoscopic endonasal resection of a pituitary adenoma.By Jessa E. Miller; Jakob L. Fischer and Marilene B. WangReported by Author; Author; Author [Extracted from the article]

This article discusses the use of different techniques for skull base reconstruction in endoscopic pituitary surgery and their association with cerebrospinal fluid (CSF) leaks. The Hadad-Bassagasteguy nasoseptal flap (NSF) has been effective in reducing CSF leaks, but there is limited data on the appearance of different reconstruction techniques on MRI and their relationship to CSF leak rates. The study reviewed patient data and imaging to compare the vascularization patterns of free mucosal grafts (FMG) and NSF, and found that patients with NSF reconstruction had higher rates of intraoperative CSF leaks. However, there was no association between patterns of flap enhancement on MRI and CSF leaks. FMGs showed a predictable change in enhancement pattern over 3 months, while NSFs without flap enhancement at 1 week still demonstrated neovascularization without increased risk of complications. [Extracted from the article]

This article, titled "Endoscopic Skull Base Surgery among Pediatric Patients: A 14-Year Review," explores the use and outcomes of endoscopic skull base surgery in pediatric patients. The study analyzed data from a tertiary care center from 2009 to 2023 and compared pediatric patients (under 18 years old) to adult patients. The most common indication for surgery in both groups was a pituitary adenoma. The study found that the rate of intraoperative cerebrospinal fluid (CSF) leaks was high in both pediatric and adult patients, but postoperative CSF leaks were rare. The length of hospital stay after surgery was similar for both groups. [Extracted from the article]