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Background The pedicled nasoseptal flap (NSF) constitutes the primary reconstructive option for most skull base defects in endonasal endoscopic approaches. The superior nasal turbinate (ST) has received little attention. We report our preliminary experience with the use of the ST mucosal flap in selected cases. Methods We performed a retrospective review of patients who underwent endonasal endoscopic approaches and identified 9 patients who were reconstructed with vascularized ST mucosal flaps as part of a double-layer or triple-layer reconstruction. When there was no intraoperative cerebrospinal fluid (CSF) leak, we used a double-layer technique. If there was an intraoperative CSF leak, regardless of the quality of leakage, we preferred a triple-layer repair technique. In patients with high-flow leaks, triple-layer repair was performed using only autologous tissue grafts and flaps. Results Intraoperative CSF leaks were noted in 7 of 9 patients. Among them, 4 patients had low-flow CSF leaks (grade 1 and 2) and 3 patients had high-flow CSF leaks (grade 3). All reconstructions had complete defect coverage with the ST flaps and NSFs were preserved. All the flaps were viable at 4 weeks without a CSF leak or complication at the reconstruction site. There was no contraction or partial loss of the flap. After a mean follow-up period of 9 months, none of the patients required a flap revision, developed a mucocele, infection, or other complication. Conclusions An ST flap can be used for the vascularized reconstruction of sellar defects if it is bilaterally available. This option should not be overlooked and wasted.

Objective To map different areas of pain sensitivity and to determine the existence and/or pattern of referred pain from upon stimulating the sinonasal cavity. Study design Experimental human study. Methods Mechanical and electrical stimulations to various anatomical structures and areas of the nasal and sinus cavities were conducted on nine volunteers. Intensity, location and character of pain were recorded in all subjects. Results The postero-superior (cephalic) aspect of the nasal cavity, primarily the anterior face of the sphenoid sinus and the superior turbinate, were the most sensitive sites, and the antero-inferior (caudal) region was the least sensitive. Referred pain to the head and face was reported by several subjects. Conclusion Topographical differences in pain sensitivity exist in the sinonasal cavity. The phenomenon of referred pain from the nasal cavity was demonstrated.

We describe surgical treatment of a hemangiopericytoma in the anterior skull base and nasal cavity. The patient underwent a novel method of anterior skull base reconstruction, using the superior turbinate and cerebral falx, which was successful. The patient did not develop a cerebrospinal fluid leak or intracranial infection.

Turbinate osteoma is very rare and only three middle turbinate cases have been previously reported in the literature. A case of superior turbinate osteoma has never been reported before. This is a report of a 61-year-old female presenting superior turbinate osteoma with headaches. The osteoma was resected by endoscopic sinus surgery (ESS) and the patient was relieved of headaches.

The inferior turbinate is a separate bone that extends from the body of the maxilla to the ethmoidal crest. Its arched central portion overhangs the so-called inferior meatus, which contains the opening of the nasolacrimal duct. The inferior turbinate is part of the nasal valve area, which is the narrowest part of the nose. During inspiration, airflow is directed upward and backward, mainly over the anterior part of the inferior turbinate.l Concha bullosa, pneumatization of the middle turbinate, is a well-recognized entity. It is the most common anatomic variation of the middle turbinate leading to various clinical problems.2 It may be either unilateral or bilateral, with different sizes, and may compromise the anatomy and function of the ostiomeatal complex. Pneumatization of the superior turbinate, which is also called concha bullosa of the superior turbinate by Stammberger,3 is a very rare entity, and only a few cases have been reported. 3,4 Pneumatization of the inferior turbinate has not yet been reported in the world literature. In this article, a patient with inferior turbinate pneumatization is presented.