Endoscopic Endonasal Reconstructive Methods to the Anterior Skull Base

Seminars in Plastic Surgery
Srikant ChakravarthiAmin B Kassam

Abstract

The success of expanded endoscopic endonasal approaches (EEAs) to the anterior skull base, sellar, and parasellar regions has been greatly aided by the advancement in reconstructive techniques. In particular, the pedicled vascularized flaps have been developed and effectively cover skull base defects of varying sizes with a significant reduction in postoperative CSF leaks. There are two aims to this review: (1) We will provide our current, simplified reconstruction algorithm. (2) We will describe, in detail, the relevant anatomy, indications/contraindications, and surgical technique, with a particular emphasis on the nasoseptal flap (NSF). The inferior turbinate flap (ITF), middle turbinate flap (MTF), pericranial flap (PCF), and temporoparietal fascial flap (TPFF) will also be described. The NSF should be the primary option for reconstruction of majority of skull base defects following endonasal endoscopic surgery. In general, for the planum, cribriform, and upper two-thirds of the clivus, the NSF is ideal. For the lower-third of the clivus, the NSF may not be adequate and may require additional reconstructive options. Although limited in reach or more technically challenging, these reconstructive flaps should still be conside...Continue Reading

Citations

Jun 20, 2019·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·Mohd Afiq Mohd SlimGerald McGarry
Mar 21, 2020·American Journal of Rhinology & Allergy·John R ScottPeter-John Wormald
Aug 29, 2019·Current Opinion in Otolaryngology & Head and Neck Surgery·Liliana EinElizabeth A Nicolli
Sep 23, 2020·Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale·Kyoung Su SungJu Hyung Moon
Oct 10, 2020·Operative Neurosurgery·Matthew KimDavid A Gudis
Mar 2, 2021·Ear, Nose, & Throat Journal·Jördis Kristin EdenChristian Stephan Betz
Jan 26, 2021·Journal of Neurosurgical Sciences·Erion J DE AndradePablo F Recinos
Jun 1, 2021·World Neurosurgery·Juan M Revuelta BarberoGustavo Pradilla
Aug 28, 2021·Cancers·Florian ChateletBenjamin Verillaud

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