Objective This aim of this study was to address the outcome of endoscopic reconstruction of the sellar floor by extended inferior turbinate flap.

Patients and Methods This is a retrospective study of 34 patients with a recurrent pituitary tumor. They were treated between March 2018 and December 2021 by endoscopic extended endonasal approach with the reconstruction of the sellar floor by an extended posterior pedicle inferior turbinate flap. The clinical and radiological follow-up was performed immediately postoperation and regularly every 3 months up to 1 year, and the available data from the last follow-up visit were included in the analysis.

Results The patients' age ranged between 40 and 65 years, with a slight female predominance (55.9%). Headache was the main presentation (47.1%), and functional tumors were found in 50.0% patients. Visual disturbances were field defects among 61.8% and papilledema among 52.9% patients. Preoperative endoscopy revealed postseptectomy as the significant finding (73.5%), followed by postseptectomy and adhesion (14.7%) and finally postseptectomy and hypertrophied inferior turbinate (11.8%). Total tumor resection was achieved in 76.5%, visual improvement was recorded in 52.9%, and no complications were reported in 82.4% patients. Cerebrospinal fluid (CSF) leak was not reported in any of the studied patients. Finally, total resection was significantly associated with younger age, non-functioning tumor and improvement of headache.

Conclusion The extended inferior turbinate flap is an effective and safe approach for sellar floor reconstruction in endoscopic endonasal surgery for recurrent pituitary tumors. The extension overcomes the relatively small inferior flap and its limited arc of rotation.

目的 本研究的目的是探讨内镜下扩展下鼻甲瓣重建鞍底的结果。

患者和方法 这是一项对 34 名复发性垂体瘤患者的回顾性研究。他们于 2018 年 3 月至 2021 年 12 月期间接受了内窥镜扩展鼻内入路治疗，并通过扩展后蒂下鼻甲皮瓣重建鞍底。术后立即进行临床和放射学随访，并每 3 个月至 1 年定期进行一次，并将上次随访的可用数据纳入分析。

结果 患者年龄40~65岁，女性稍多（55.9%）。以头痛为主要表现（47.1%），50.0%的患者发现功能性肿瘤。61.8% 的患者因视野缺损而出现视力障碍，52.9% 的患者因视乳头水肿而出现视力障碍。术前内窥镜检查显示，鼻中隔切除术后是最重要的发现（73.5%），其次是鼻中隔切除术后和粘连（14.7%），最后是鼻中隔切除术后和下鼻甲肥大（11.8%）。76.5% 的患者实现肿瘤全切除，52.9% 的患者视力改善，82.4% 的患者未报告并发症。在所有研究的患者中均未报告有脑脊液（CSF）渗漏。最后，完全切除与年轻化、无功能肿瘤和头痛改善显着相关。

结论 扩大下鼻甲皮瓣是鼻内镜复发性垂体瘤手术鞍底重建的一种有效、安全的方法。延伸克服了相对较小的下瓣及其有限的旋转弧度。