Reconstruction with a novel pedicled mucoperiosteal hinge flap and dura suturing: a new minimally invasive concept and closure technique for endoscopic endonasal surgery
Abstract
ObjectsThe authors aimed to evaluate their experience with the minimally invasive reconstruction technique using pedicled mucoperiostea hinge flap (PMHF) with dura suturing after EES. Outcomes were compared with those of the traditional reconstruction using the NSF.MethodsThe authors conducted a retrospective cohort study involving 33 consecutive patients who underwent EES for pituitary adenoma resection. All these 33 patients were reconstructed with pedicled mucoperiosteal hinge flap with dura suturing and were compared with 32 consecutive patients treated previously using NSF technique. Surgical videos and electronic medical records were reviewed to assess operative times and postoperative outcomes, which were compared between the groups, with a particular focus on nasal function, assessed using the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q).ResultsDemographics of the two groups were broadly similar. Among the 33 patients using PMHF with dura suturing, the average operative time decreased with experience, showing a trend of improved efficiency. No significant difference was observed between two groups in terms of total operative time. One postoperative CSF leak (3%) was observed in PMHF group, while 2 postoperative CSF leak (6%) occurred in group using NSF (P = 0.61). Importantly, patients who underwent reconstruction with pedicled mucoperiosteal hinge flap with dura suturing reported significantly lower EES-Q scores overall (p < 0.01), with better outcomes in all domains (p < 0.01).ConclusionsThis technique provides a reliable method for preventing postoperative CSF leak and a less invasive option, ultimately contributing to the preservation of the patient’s quality of life (QOL).
Related
- Subpial dissection technique in endoscopic endonasal surgery for craniopharyngiomas with supradiaphragmatic extension
- Extended endoscopic endonasal transplanum transtuberculum approach for retrochiasmatic type II transinfundibular craniopharyngioma: operative pearls and nuances of the technique.
- Extended endoscopic endonasal resection of a transinfundibular craniopharyngioma with third ventricular extension associated with superficial siderosis: Operative technique and technical nuances.
- Unilateral biportal endoscopic thoracic costotransversectomy approach: a minimally invasive technique for thoracic disc herniation—a technical feasibility report
- Evaluation of the clinical efficacy of endoscopic endonasal dacryocystorhinostomy in treating chronic dacryocystitis
BibTeX
@article{xie2026reconstruction,
title = {{Reconstruction with a novel pedicled mucoperiosteal hinge flap and dura suturing: a new minimally invasive concept and closure technique for endoscopic endonasal surgery}},
author = {Zhengxing Xie and Chengyang Xie and Yan Zhuang and Liang Cao},
journal = {Frontiers in Oncology},
year = {2026},
month = nov,
doi = {10.3389/fonc.2026.1956884},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1956884},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Reconstruction with a novel pedicled mucoperiosteal hinge flap and dura suturing: a new minimally invasive concept and closure technique for endoscopic endonasal surgery
AU - Zhengxing Xie
AU - Chengyang Xie
AU - Yan Zhuang
AU - Liang Cao
PY - 2026
DA - 2026/11/09
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1956884
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1956884
AB - ObjectsThe authors aimed to evaluate their experience with the minimally invasive reconstruction technique using pedicled mucoperiostea hinge flap (PMHF) with dura suturing after EES. Outcomes were compared with those of the traditional reconstruction using the NSF.MethodsThe authors conducted a retrospective cohort study involving 33 consecutive patients who underwent EES for pituitary adenoma resection. All these 33 patients were reconstructed with pedicled mucoperiosteal hinge flap with dura suturing and were compared with 32 consecutive patients treated previously using NSF technique. Surgical videos and electronic medical records were reviewed to assess operative times and postoperative outcomes, which were compared between the groups, with a particular focus on nasal function, assessed using the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q).ResultsDemographics of the two groups were broadly similar. Among the 33 patients using PMHF with dura suturing, the average operative time decreased with experience, showing a trend of improved efficiency. No significant difference was observed between two groups in terms of total operative time. One postoperative CSF leak (3%) was observed in PMHF group, while 2 postoperative CSF leak (6%) occurred in group using NSF (P = 0.61). Importantly, patients who underwent reconstruction with pedicled mucoperiosteal hinge flap with dura suturing reported significantly lower EES-Q scores overall (p < 0.01), with better outcomes in all domains (p < 0.01).ConclusionsThis technique provides a reliable method for preventing postoperative CSF leak and a less invasive option, ultimately contributing to the preservation of the patient’s quality of life (QOL).
SN - 2234-943X
ER -