A Systematic Review of Sphenoid Sinus Mucosal Flap Reconstruction Following Transsphenoidal Surgery

Abstract

Background: Effective skull base reconstruction is a key element of transsphenoidal surgery, particularly for preventing complications such as cerebrospinal fluid (CSF) leaks. The sphenoid mucosa, a membrane lining the sphenoid sinus, can play a critical role in sellar reconstruction. Methods: Following PRISMA 2020 guidelines, this systematic review focused exclusively on full-text articles published in English between 2014 and 2024. Result: The study conducted a comprehensive review of over 200 publications sourced from reputable databases, including ScienceDirect, SagePub, and PubMed. Following an initial screening, five publications were identified as warranting more in-depth analysis. Consequently, a thorough review of these selected studies was performed to ensure a detailed and rigorous evaluation. Conclusion: The sphenoid mucosal flap appears to be a promising technique for skull base reconstruction after transsphenoidal surgery. Its use not only reduces reliance on avascular grafts like fat but also lowers the incidence of local complications, such as necrosis and infection while promoting better sinonasal healing. By preserving vascularization, SMF may enhance wound healing and contribute to the restoration of the sphenoid sinus's posterior wall. However, further clinical studies are necessary to explore the benefits of SMF preservation and its combination with other techniques, especially for addressing higher-grade CSF leaks.