Reconstruction Using Nasal Septum

Meningo encephalocele pre op CT Scan

Meningo encephalocele pre op CT Scan.

Meningo encephalocele post op CT scan

Meningo encephalocele post op CT scan.

Meningo encephalocele

Meningo encephalocele – septal flap rotation post op.

CT Scan

CT Scan of post left maxillectomy defect with recurrent benign tumour (osteoblastoma) on opposite side.

hard palate

Septal flap reconstruction of roof mouth (hard palate)

Reconstruction of bony walls of anterior skull base and hard palate are necessary following excision of lesions.

The anterior skull base contains the cranial contents and has to resist the pressure that tends to push down. Hence defects larger than 10mm require hard tissue reconstruction. In our patients we perform both excision of lesion and septal reconstruction of defect trans nasally with endoscopic nasal surgery. This obviates the need for any external facial skin incision.The hard palate in the same manner is important for holding food and fluids within the mouth during eating. Without this structure one cannot rinse the mouth by gargling. Prosthetic reconstruction is not the best substitute as several limitations inconvenience the patient. Even the best fitted prosthesis does not allow free chewing of food on the prosthesis side despite presence of artificial teeth incorporated in the denture. By using the hard bone covered nasal septum a naturel hard palate can be reconstructed which allows a bed for simple denture, which fulfills chewing function. This reconstruction is also waterproof and by restoring of natural arch of palate allows natural normal voice production as before the excision surgery. This procedure is done here primarily during excision of lesions of upper jaw. The procedure is also done for patients who have undergone excision of hard palate elsewhere as a secondary reconstruction operation.