Reconstruction of a large anterior skull base defect with a multilayer graft augmented by a vascularized flap: A technical note

Document Type : Original Article

Authors

1 Department of ORL – HNS, Assiut University, Faculty of Medicine, Assiut, Egypt

2 Department of ORL– HNS, Alexandria University, Faculty of Medicine, Alexandria, Egypt.

3 Department of OR– HNS, Assiut University, Faculty of Medicine, Assiut, Egypt

4 Department of ORL– HNS, Assiut University, Faculty of Medicine, Assiut, Egypt

5 Department of Neurosurgery, Assiut University, Faculty of Medicine, Assiut, Egypt.

Abstract

Skull base reconstruction of the anterior cranial fossa after the excision of large sinonasal or skull base tumors is still a challenge. The local flaps may be not available or insufficient to seal the whole defect. Harvesting regional flaps or free flap is a time-consuming procedure that may increase postoperative morbidity. We report a technique for reconstruction of anterior skull base using autologous grafts covered by free mucosal graft that is augmented by vascularized flaps in 2 cases. A 51 years old female patient with olfactory neuroblastoma underwent endonasal endoscopic resection followed by multilayer reconstruction using 3 layers of fascia lata sandwiched between a mucosal graft from above and double middle turbinate flaps from below. The second case was 48 years old male patient with non-intestinal type adenocarcinoma invading the anterior skull base. The resection of the tumor was done endoscopically and 3 layers of fascia lata were utilized and covered by a mucosal graft from above and the nasoseptal flap from below for reconstruction. No postoperative CSF leak was reported in either case. The graft augmented flap technique was effective that prevent postoperative morbidity.
 

Keywords

Egyptian Journal of Neck Surgery and Otorhinolaryngology
Volume 7, Issue 3
December 2021
Pages 1-8

Files

Share

How to cite

Statistics