BACKGROUND Indications for expanded endoscopic approaches continue to grow, resulting in larger and more complex skull base defects. Reconstructive developments, however, have lagged our extirpative capabilities. As the complexity of clinical scenarios continues to escalate, challenging our current reconstructive strategies, we are compelled to develop alternative techniques to prevent cerebro...

OBJECTIVES/HYPOTHESIS Failure in skull base defects reconstruction following tumor resection can have serious consequences such as ascending meningitis and pneumocephaly. The nasoseptal flap showed a very low incidence of cerebrospinal fluid leak but is not always available. The superiorly pedicled facial artery musculomucosal (FAMM) flap has been successfully used for reconstruction of head an...

OBJECTIVES/HYPOTHESIS We sought to analyze key factors that influence the management of lateral skull base defects and implement an algorithm to improve outcomes of reconstruction. STUDY DESIGN Retrospective chart review. SETTING Single tertiary academic referral center. METHODS Adults who underwent temporal bone resection were included. Variables included tumor characteristics, ablative ...

OBJECTIVES/HYPOTHESIS The objective of this study was to utilize techniques of otopathology to gain insight into the pathogenesis, sites of origin, and associated findings in idiopathic lateral skull base defects. STUDY DESIGN Histopathologic analysis of temporal bones from an otopathology repository. METHODS Specimens from a human temporal bone repository were investigated for clinical or ...

OBJECTIVES Defects after endoscopic expanded endonasal approaches (EEA) to the skull base, have exposed limitations of traditional reconstructive techniques. The ability to adequately reconstruct these defects has lagged behind the ability to approach/resect lesions at the skull base. The posteriorly pedicled nasoseptal flap is our primary reconstructive option; however, prior surgery or tumors...

OBJECTIVES One of the major challenges of cranial base surgery is reconstruction of the dural defect. Following a craniofacial resection, the standard reconstructive technique is direct suture repair of the dural defect with a fascial graft and rotation of an anteriorly based pericranial scalp flap to cover the dura. The introduction of endoscopic techniques and an endonasal approach to the ven...

Reconstruction materials and techniques for the base of the skull have undergone rapid developments and differentiation in recent years. While mostly autotransplants, collagens or resorbable alloplastic materials are preferred for duraplasties, pronounced organ-specific differences can be observed in the reconstruction of hard tissues. The use of polymethylmethacryl bone cement, once wide-sprea...

BACKGROUND In patients with large dural defects of the anterior and ventral skull base after endonasal skull base surgery, there is a significant risk of a postoperative cerebrospinal fluid leak after reconstruction. Reconstruction with vascularized tissue is desirable to facilitate rapid healing, especially in irradiated patients. METHODS We developed a neurovascular pedicled flap of the nas...

BACKGROUND The temporalis muscle flap (TMF) is a valuable reconstructive technique utilized in a variety of challenging defects. However, its use for repair of skull base defects is less commonly reported. METHODS A retrospective chart review was conducted for 35 patients who underwent reconstruction of skull base defects between March 1999 and July 2006 at a tertiary referral hospital. Patie...