{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T14:43:31Z","timestamp":1794408211519,"version":"4.9.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background\u2003The endoscopic endonasal approach (EEA) has become increasingly used for resection of skull base tumors in the sellar and suprasellar regions. A nasoseptal flap (NSF) is routinely used for anterior skull base reconstruction; however, there are numerous additional allografts and autografts being used in conjunction with the NSF. The role of perioperative cerebrospinal fluid (CSF) diversion is also unclear.<\/jats:p><jats:p>Objective\u2003This study was aimed to analyze success of high-flow CSF leak repair during EEA procedures without use of CSF diversion through lumbar drainage.<\/jats:p><jats:p>Methods\u2003A retrospective chart review of patients who had intraoperative high-flow CSF leak during EEA procedures at our institution between January 2013 and December 2017 was performed. CSF leaks were repaired with use of a fascia lata button graft and nasoseptal flap, without use of perioperative lumbar drains.<\/jats:p><jats:p>Results\u2003A total of 38 patients were identified (10 male, 28 female). Patient BMIs ranged from 19.7 to 49\u2009kg\/m2 (median\u2009=\u200931\u2009kg\/m2), with 18 patients meeting criteria for obesity (BMI\u2009&gt;\u200930\u2009kg\/m2) and 12 patients overweight (25\u2009kg\/m2\u2009&lt;\u2009BMI\u2009&lt;\u200929.9\u2009kg\/m2). There was no incidence of postoperative CSF leak.<\/jats:p><jats:p>Conclusion\u2003In our experience, the nasoseptal flap used in conjunction with the fascia lata button graft is a safe, effective and robust combination for cranial base reconstruction with high-flow intraoperative CSF leaks, without need for lumbar drains.<\/jats:p>","DOI":"10.1055\/s-0039-1693124","type":"journal-article","created":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T22:53:21Z","timestamp":1564613601000},"page":"645-650","source":"Crossref","is-referenced-by-count":15,"title":["Endoscopic Endonasal Reconstruction of High-Flow Cerebrospinal Fluid Leak with Fascia Lata \u201cButton\u201d Graft and Nasoseptal Flap: Surgical Technique and Case Series"],"prefix":"10.1055","volume":"81","author":[{"given":"Roshni V.","family":"Khatiwala","sequence":"additional","affiliation":[{"name":"Albany Medical College, Albany, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5018-0685","authenticated-orcid":false,"given":"Karthik S.","family":"Shastri","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\/Head and Neck Surgery, Department of Surgery, Albany Medical Center, Albany, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Peris-Celda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Albany Medical Center, Albany, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Kenning","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Albany Medical Center, Albany, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos D.","family":"Pinheiro-Neto","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\/Head and Neck 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