Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note

Brazilian Journal of Otorhinolaryngology
Ricardo Landini Lutaif DolciPaulo Roberto Lazarini

Abstract

One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base. Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy. Step by step description of the endoscopic double flap technique (nasoseptal and pericranial vascularized flaps and fascia lata free graft) as used and illustrated in two patients with an olfactory groove meningioma who underwent an endoscopic approach. Both patients achieved a gross total resection: subsequent reconstruction of the anterior skull base was performed with the nasoseptal and pericranial flaps onlay and a fascia lata free graft inlay. Both patients showed an excellent recovery, no signs of cerebrospinal fluid leak, meningitis, flap necrosis, chronic meningeal or sinonasal inflammation or cerebral herniation having developed. Th...Continue Reading

Citations

May 29, 2018·Journal of Neurosurgical Sciences·Alexandre B TodeschiniDaniel M Prevedello
Jun 1, 2021·World Neurosurgery·Juan M Revuelta BarberoGustavo Pradilla

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