Complications of basilar skull fracture, such as carotid cavernous fistulae, meningitis, cerebrospinal fluid rhinorrhoea and otorrhoea, pneumatocele, and various cranial nerve disturbances, are well known (Gurdjian and Webster, 1958). In -addition, unilateral thrombosis of the internal carotid artery, both with and without basilar skull fracture, has frequently been reported after closed head a...

Different reconstruction techniques of the anterior and middle skull base as consequence of a defect after surgical treatment of neoplastic pathologies are described in the literature. The aim of the present study is to present our experience regarding the use of microvascular free flaps for reconstruction of the anterior or middle skull base after large defects caused by removal of malignant n...

OBJECTIVES/HYPOTHESIS To conceive and critically evaluate an adaptation of the split calvarial osteopericranial flap for reconstruction following endoscopic endonasal resection of the anterior skull base. STUDY DESIGN Cadaveric anatomic study. METHODS Five cadavers were embalmed with methanol, and vasculature was injected with latex. Endoscopic endonasal resection of the anterior skull base...

localization of brain lesions and prevention of damage to vital structures are important in operation of brain pathologies. despite development of many techniques including angiography, mri, sonography, and frame base stereotaxy, a more accurate localizing technique is still needed (1, 2). a step forward to achieve this goal is to develop a navigation system. in this manuscript, we explained so...

OBJECTIVE To present our method for anterior skull base reconstruction after oncological resections. METHODS One hundred nine patients who had undergone 120 anterior skull base resections of tumors (52 malignant [43%], 68 benign [57%]) via the subcranial approach were studied. Limited dural defects were closed primarily or reconstructed using a temporalis fascia. Large anterior skull base def...

BACKGROUND To evaluate the efficacy of using a galeopericranial flap for reconstruction of anterior cranial base defects. METHODS In Linkou Chang Gung Memorial Hospital from February 1994 to November 2003, 25 patients who had tumors of the skull base underwent craniofacial resection, and a galeopericranial flap was used to reconstruct the anterior cranial base defect. The galeopericranial fla...

OBJECTIVE To offer an algorithm for airway management in anterior skull base surgery. METHODS This is a retrospective review of 109 patients undergoing major anterior skull base surgery from a single senior surgeon's experience from September 1997 to May 2006. RESULTS We report only one (1%) postoperative mortality in this series and only seven major complications in six patients, including...

OBJECTIVES/HYPOTHESIS Endoscopic endonasal skull base surgery defects require effective reconstruction. Although the nasoseptal flap (NSF) has become our institution's workhorse for large skull base defects with cerebrospinal fluid (CSF) leaks, situations where it is unavailable require secondary flaps. Clinical outcomes, pearls and pitfalls, and an algorithm will be presented for these seconda...

BACKGROUND Modern microsurgical techniques enable en bloc resection of complex skull base tumors. Anterior cranial base surgery, particularly, has been associated with a high rate of postoperative cerebrospinal fluid (CSF) leak, meningitis, intracranial abscess, and pneumocephalus. We introduce simple modifications to already existing surgical strategies designed to minimize the incidence of po...

Treatment goals following skull base surgery have shifted over the last decade to improving functional outcomes and quality of life. Given the intimacy of skull base tumors to vital structures, the potential for morbidity, functional impairments, and a decline in quality of life after surgery is possible. The endoscopic endonasal approach may have potential functional outcome and quality of lif...