Use of Acoustic Doppler Sonography to Ascertain the Feasibility of the Pedicled Nasoseptal Flap After Prior Bilateral Sphenoidotomy

Objectives/Hypothesis: Blood supply to the Hadad-Bassagasteguy pedicled nasoseptal flap may be interrupted by surgery of the pterygopalatine fossa, posterior septectomy, or large sphenoidotomies. This would preclude its use for reconstruction of skull base defects after expanded endonasal approaches (EEA). We present a novel method to ascertain the patency of the nasoseptal artery after prior surgery, and consequently the availability of the nasoseptal flap, using acoustic Doppler sonography. Study Design: Retrospective clinical review. Methods: Four patients who underwent EEAs were evaluated intraoperatively with acoustic Doppler sonography. The mucosa that covers the inferior aspect of the rostrum of the sphenoid sinus was scanned with the tip of the probe. Reflection of sound waves representing intravascular blood flow was assessed. Results: In three patients, the artery was identified in at least one side. One remaining patient showed no acoustic signal suggesting loss of the nasoseptal artery bilaterally, therefore necessitating the use of a fat graft for the reconstruction. Conclusions: Acoustic Doppler sonography seems to be a feasible and effective way to ascertain the availability of the nasoseptal artery. It is a relatively inexpensive and simple technique that can be performed by any endoscopic surgeon.

Flora of Guatemala / Paul C. Standley and Julian A. Steyermark.

v.24:pt.3(1952)

Flora of Guatemala / Paul C. Standley and Louis O. Williams.

v.24:pt.8:no.3(1967)

Flora of Guatemala / Paul C. Standley and Louis O. Williams.

v.24:pt.9:no.3-4(1973)

Flora of Guatemala / Paul C. Standley and Louis O. Williams.

v.24:pt.7:no.1(1961)

Flora of Guatemala / Paul C. Standley and Louis O. Williams.

v.24:pt.7:no.4(1963)

Flora of Guatemala / Paul C. Standley and Louis O. Williams.

v.24:pt.7:no.2(1962)

Flora of Guatemala / Paul C. Standley and Julian A. Steyermark.

v.24:pt.6(1949)

Flora of Guatemala / Paul C. Standley and Louis O. Williams.

v.24:pt.9:no.1-2(1970)

Flora of Guatemala / Paul C. Standley, Louis O. Williams, Dorothy Nash Gibson.

v.24:pt.10:no.3-4(1974)

Flora of Guatemala / Paul C. Standley and Louis O. Williams.

v.24:pt.8:no.4(1969)

Flora of Guatemala / Paul C. Standley and Louis O. Williams.

v.24:pt.8:no.1-2(1966)

Vegetable materia medica of the United States, or, Medical botany :containing a botanical, general, and medical history of medicinal plants indigenous to the United States. Illustrated by coloured engravings, made after drawings from nature, done by the author /by William P.C. Barton.

v. 1

Vegetable materia medica of the United States, or, Medical botany :containing a botanical, general, and medical history of medicinal plants indigenous to the United States. Illustrated by coloured engravings, made after drawings from nature, done by the author /by William P.C. Barton.

v. 2

Observations on the dipteran fauna in a focus of dermal leishmaniasis in the State of Minas Gerais: II. The distribution of families in relation to their medical, veterinary and economic importance

Miniature light traps used to collect Phlebotominae in a focus of dermal leishmaniasis in the eastern part of the State of Minas Gerais, Brazil. Over a period of seven months, the other Diptera captured in 179 light trap samples were identified to family level. The traps were placed in eight localities which constituted three different biotopes: three woodland aresas, cultivated land, and a peridomestic site. A comparison is made between the totals of Dipeterans collected in each biotope, the total numbers of families collected in each biotope and the estimated indices of diversity. Dendograms representing the degrees of association between families of Diptera in different biotopes are presented. Some families of Diptera are uniformly distributed throughout the study area; a few families seem to have become adapted to areas where human activity has induced the greatest ecological changes. The impact between Dipterans and human well-being is discussed. The availabel evidence indicates that transmission of dermal leishmaniasis does not occur in areas where sand flies can be captured in greatest densities.