How Can Skull Base Defects be Reliably Reconstructed?

Abstract

Background: A variety of material and techniques have been introduced for endoscopic repair of idiopathic or traumatic CSF leak. With the evolution of endoscopic approaches and the expansion of their use to intradural lesions, their most demanding complication, post-operative CSF leak, should be addressed to let them survive.  Use of pedicled local flap and the most common one, nasoseptal flap has evolved the reconstruction of skull base defects after these approaches.

Materials and Methods: From June 2011 t0 July 2014, nasoseptal flap has been used for skull base reconstruction in 80 cases with various skull base pathologies including CSF leak from Sternberg canal, pituitary adenoma, craniopharyngioma and adenoid cystic carcinoma with intracranial extension in adults and children.

Results: Only 1 case of flap failure (due to technical problem) was encountered.  Pros and cons of using the flap along with tips and tricks in the technique will be discussed on movies.

Conclusion: Skull base reconstruction using nasoseptal flap is quite a reliable technique when dealing with high flow CSF leak in extended endoscopic endonasal approaches.