Technical nuances of commonly used vascularised flaps for skull base reconstruction

Background and Methods: Reconstruction with a vascularised flap provides the most reliable outcome, with postoperative cerebrospinal fluid leak rates of less than 5 per cent. This article aims to review and summarise the critical technical aspects of the vascularised flaps most commonly used for skull base reconstruction. Results: Vascularised flaps are classified as intranasal or extranasal. The intranasal group includes the Hadad–Bassagaisteguy nasoseptal flap, the Caicedo reverse nasoseptal flap, the nasoseptal rescue flap, the posteriorly or anteriorly based lateral wall flaps, and the middle turbinate flap. Extranasal flaps include the transfrontal pericranial and transpterygoid temporoparietal flaps. Conclusion: The Hadad–Bassagaisteguy nasoseptal flap is overwhelmingly favoured for reconstructing extensive defects of anterior, middle and posterior cranial base. Its pertinent technical features are described. However, it is essential to master the skills required for the various extranasal or regional vascularised flaps because each can offer a reconstructive alternative for specific patients, especially when open approaches are needed and/or intranasal vascularised flaps are not feasible

Simulating seasonal variability of phytoplankton in stream water using the modified SWAT model

The ability to simulate algal systems is critical for watershed-scale models. The objective of this study was to develop and evaluate a modified algal module that simulates the dynamics of three major algal groups (cyanobacteria, green algae, and diatoms) in a stream using variables available in the Soil and Water Assessment Tool. The proposed module 1) models the dynamics of the three algal groups while accounting for nutrients from algal die-off and 2) has temperature multipliers that consider the effect of temperature changes on kinetic rates. Data to test the module were collected from a forest-dominated watershed over two years. The modified module was efficient in predicting seasonal variations in algal group biomass and simulated the regeneration of nutrients after algal die-off. This module will be useful in predicting the dynamics of the three studied algal groups and evaluating the best management practices for algal blooms in watersheds