Evidence map›Paper›PMID 41504970›Full record

ArticleNeurosurgical review2026

Comparison of two novel options for resuspension of inverted U-shaped nasopharyngeal flap following endonasal access to cranio-vertebral junction: Pilot cadaveric analysis and illustrative case report.

Beatrice Zucca, Marissa Koscielski, John Na, Andrea de Gregorio, Ian Smith, Joel Kaye, Ahmad R Sedaghat, Samer Hoz, Charles J Prestigiacomo, Rani M Nasser and 4 more

Abstract readComparative StudyCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Beatrice ZuccaAlma Mater Studiorum-University of Bologna, Bologna, Italy.
Marissa KoscielskiUniversity of Cincinnati College of Medicine, Cincinnati, OH, USA.
John NaUniversity of Cincinnati College of Medicine, Cincinnati, OH, USA.
Andrea de GregorioUniversità di Milano, Milano, Italy.
Ian SmithUniversity of Cincinnati College of Medicine, Cincinnati, OH, USA.
Joel KayeDepartment of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Ahmad R SedaghatDepartment of Otolaryngology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Samer HozDepartment of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Charles J PrestigiacomoDepartment of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Rani M NasserDepartment of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Justin N VirojanapaDepartment of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Norberto O AndaluzDepartment of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Katie M PhillipsDepartment of Otolaryngology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Jonathan A ForbesDepartment of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, OH, USA. forbesjh@ucmail.uc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Suturing in the narrow endonasal corridor can be technically challenging. For some endonasal procedures, including inverted U-shaped nasopharyngeal flap (IUNF) harvest for cranio-cervical junction exposure, the ability to support meticulous flap resuspension offers clinical utility. Two novel suturing techniques offer promise: (1) use of barbed suture and (2) Durastat dural repair device, obviating the need for knot tying and endonasal needle driver/supination, respectively. Perform subjective and objective evaluation of IUNF resuspension with: (1) running mucosal suturing using endonasal needle driver and barbed, loop suture and (2) interrupted mucosal suturing using the Durastat device in 3 cadaveric heads. A IUNF was created and subsequently resuspended, (1) using a 3-0 monocryl barbed Stratafix with loop and endonasal needle driver. After Stratafix suture removal, (2) resuspension using interrupted sutures with the Durastat, spring loaded device was performed. Repair time was measured objectively. Suture precision was subjectively evaluated. Adequate IUNF resuspension was provided by both methods (3/3). The barbed suture required more procedural time on average (18:59 minutes), than the Durastat system (18:35 minutes). The small Durastat needle often failed to puncture the mucosal flap using spring mechanism alone, indicating that technical modification to increase needle size and spring torque could improve performance. Adequate mucosal resuspension was achieved in all specimens. Stratafix offered greater consistency with needle puncture and similar precision but was more technically challenging compared to the Durastat system. With appropriate technological modifications, the authors believe the Durastat system has greater potential to optimize IUNF resuspension.

Indexed as

Cervical VertebraeNasopharynxNeurosurgical ProceduresSurgical FlapsSuture TechniquesCadaverHumansPilot ProjectsBarbed loop sutureDurastat system.EndonasalEndonasal suturingEndoscopicFlap resuspension

Identifiers

PMID41504970
PMCPMC12783318

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.