{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:35:35Z","timestamp":1761824135040},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T00:00:00Z","timestamp":1567987200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215119001841_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The indications for expanded endoscopic transnasal approaches continue to increase, with more complex skull base defects needing to be repaired. This study reviews the management of large anterior skull base defects with opening of the sellar diaphragm.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215119001841_sec_a2\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>A prospective analysis of endonasal endoscopic surgery carried out at Son Espases University Hospital between January 2013 and December 2018 was performed. The analysis included only the cases with a significative intra-operative cerebrospinal fluid leak. In all cases, reconstruction was performed by combining the gasket seal technique with a pedicled mucosal endonasal flap.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215119001841_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Twenty-eight patients were included. The mucoperiosteal nasoseptal flap, the lateral wall flap and the middle turbinate flap were used in 13, 8 and 7 patients, respectively, combined with the gasket seal technique. One case of post-operative cerebrospinal fluid leak was observed (3.57 per cent).<\/jats:p><\/jats:sec><jats:sec id=\"S0022215119001841_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>The combination of a gasket seal with an endonasal mucosal flap is an excellent technique for repairing large anterior skull base defects.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215119001841","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T08:40:35Z","timestamp":1568018435000},"page":"889-894","source":"Crossref","is-referenced-by-count":7,"title":["Endoscopic reconstruction of large anterior skull base defects with opening of the sellar diaphragm. 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