How to: Nasoseptal Flap to Repair Large Maxillary Sinus Floor Defects

by John R. Craig, MD, Matthew Kim, MD, Daniel B. Spielman, MD, Jonathan Overdevest, MD, Tamer Ghanem, MD, and David A. Gudis, MD •

Carefully removing the turbinate stumps and bone in this region significantly enhanced pedicle mobility. The NSF was then advanced to cover the entirety of the maxillary sinus floor without tension. Adherus dural sealant was then placed over all flap edges. No additional intranasal packing was placed.

RESULTS

The patient’s neck fistula closed, the abscess resolved, and he had no long-term sinonasal mucopurulence, crusting, or epiphora. He had premorbid left upper lip and cheek hypesthesia after his prior maxillectomy, but no new hypesthesia.

In conclusion, NSFs can be used to repair large maxillary sinus floor defects when transoral options are infeasible. Future studies will be beneficial in determining which intranasal flaps are optimal for closing OAFs of different sizes and locations.