About: Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of SARS-CoV-2/COVID-19

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About: Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of SARS-CoV-2/COVID-19 Goto Sponge NotDistinct Permalink

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Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of SARS-CoV-2/COVID-19
Creator	Anderson Eloy, Jean Eloy, Jean Grube, Jordon Hsueh, Wayne Liu, James Talmor, Guy
source	Elsevier; Medline; PMC; WHO
abstract	ABSTRACT Background A novel viral strain known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created a worldwide pandemic known as Coronavirus 2019 (COVID-19). Early reports from China highlighted the risks associated with performing endoscopic endonasal skull base surgery in patients with SARS-CoV-2. We present a rare complication of nasoseptal flap (NSF) necrosis associated with COVID-19, further emphasizing the challenges of performing these procedures in this era. Case Description A 78-year-old male underwent an extended endoscopic endonasal transplanum resection of a pituitary macroadenoma for decompression of the optic chiasm. The resulting skull base defect was repaired using a pedicled nasoseptal flap (NSF). The patient developed meningitis and a cerebrospinal fluid (CSF) leak on post-operative day thirteen requiring revision repair of the defect. Twelve days later, he developed persistent fevers and rhinorrhea. The patient was re-explored endoscopically, and the NSF was noted to be necrotic and devitalized with evident CSF leakage. At that time, the patient tested positive for Sars-CoV-2. Post-operatively, he developed acute respiratory distress syndrome complicated by hypoxic respiratory failure and death. Conclusion To our knowledge, this is the first reported case of NSF necrosis in a patient with COVID-19. We postulate that the thrombotic complications of COVID-19 may have contributed to vascular pedicle thrombosis and NSF necrosis. Although the pathophysiology of SARS-CoV-2 and its effect on the nasal tissues is still being elucidated, this case highlights some challenges of performing endoscopic skull base surgery in the era of COVID-19.
has issue date	2020-05-29(xsd:dateTime)
bibo:doi	10.1016/j.wneu.2020.05.237
bibo:pmid	32479908
has license	els-covid
sha1sum (hex)	61e1c3a7b20ee364886ac7c4147c9cd3e84ddc6b
schema:url	https://doi.org/10.1016/j.wneu.2020.05.237
resource representing a document's title	Nasoseptal Flap Necrosis After Endoscopic Skull Base Surgery in the Setting of SARS-CoV-2/COVID-19
has PubMed Central identifier	PMC7256530
has PubMed identifier	32479908
schema:publication	World Neurosurg
resource representing a document's body	covid:61e1c3a7b20ee364886ac7c4147c9cd3e84ddc6b#body_text
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