Endoscopic reconstruction of frontal, cribiform and ethmoid skull base defects

David Chin*, Richard J. Harvey

*Corresponding author for this work

    Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

    12 Citations (Scopus)

    Abstract

    Endoscopic skull base reconstruction (ESBR) is an established option for complete reconstruction of the anterior skull base (ASB). While free mucosal grafts are still relevant for limited defects (<10 mm), the evolution of vascular flaps has extended the limits of reconstruction with up to 94% success in defect closure and avoidance of cerebrospinal fluid (CSF) leak. This article discusses the planning and execution in ESBR for anterior fossa defects. Factors influencing the choice of reconstruction (flap location, size, influence of raised intracranial pressure, high flow CSF leak, radiotherapy) are examined. The reconstructive options are discussed, including the nasoseptal flap (NSF), inferior turbinate pedicled flap and the endopericranial flap, with particular emphasis on the technical aspects of reconstruction using the NSF. A step-by- step description, with an accompanying video, is provided. Techniques applicable to ESBR in general (subdural graft placement, graft/flap placement, barrier and support dressing) are covered. Novel flaps for ASB reconstruction are also briefly-described.

    Original languageEnglish
    Title of host publicationComprehensive techniques in csf leak repair and skull base reconstruction
    EditorsBenjamin S. Bleier
    Place of PublicationBasel
    PublisherS. Karger AG
    Pages104-118
    Number of pages15
    Volume74
    ISBN (Electronic)9783805599535
    ISBN (Print)9783805599528
    DOIs
    Publication statusPublished - 2013

    Publication series

    NameAdvances in Oto-Rhino-Laryngology
    PublisherKarger
    Volume74
    ISSN (Print)0065-3071

    Keywords

    • CEREBROSPINAL-FLUID LEAKS
    • NASOSEPTAL FLAP RECONSTRUCTION
    • INFERIOR TURBINATE FLAP
    • BUCCINATOR FAB FLAP
    • PERICRANIAL FLAP
    • SEPTAL FLAP
    • SURGERY
    • REPAIR
    • MENINGITIS
    • RESECTIONS

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