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J Neurol Surg B Skull Base
DOI: 10.1055/a-2724-4410
Original Article

Reconstruction of the Skull Base Using Temporalis Fascia after Endoscopic Resection of Advanced Nasal Sinus Cancer: A Step-by-step Video

Autoren

  • Cyril Bellon

    1   Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France

  • Damien Bresson

    2   Neurosurgery Department, Foch Hospital, Université Paris Saclay, Suresnes, France

  • Mihai Malcoci

    2   Neurosurgery Department, Foch Hospital, Université Paris Saclay, Suresnes, France

  • Victoire Ardant

    3   Department of Head and Neck, C. H. U. Dupuytren, Limoges University, Limoges, France

  • Antoine Moya-Plana

    1   Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France

  • Nadia Benmoussa 

    1   Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France
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Abstract

Objectives

Surgical resection of rhinopharyngeal and anterior skull base tumors is complex, and the endoscopic endonasal approach is preferred when feasible. The risk of carotid exposure, dura mater exposure, and osteoradionecrosis necessitates covering these structures. Local flaps may not always be feasible in certain situations (prior surgeries, tumor extensions). In such cases, reconstruction using a pedicled temporalis fascia flap can be considered. The aim of this article is to elucidate, through a video, the surgical procedure.

Materials and Methods

This involves a video accompanied by anatomical drawings of a 37-year-old patient with a right-sided recurrent adenoid cystic carcinoma of the rhinopharynx treated with a right-sided type III rhinopharyngectomy with sphenoid base milling.

Results

The video explicates the key aspects of this surgery, including patient positioning, flap harvesting, flap passage, and placement in the resection area.

Conclusion

The pedicled temporalis fascia flap represents a reliable alternative for reconstructions of the rhinopharynx and skull base when local flaps are no longer viable.

Keywords

temporalis flap - endonasal surgery - salvage surgery

Note

This manuscript supplements the Operative Techniques video presentation, which can be viewed electronically.




Publikationsverlauf

Eingereicht: 17. Juni 2025

Angenommen: 13. Oktober 2025

Accepted Manuscript online:
17. Oktober 2025

Artikel online veröffentlicht:
31. Oktober 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Fernandez-Miranda JC, Hwang P, Grant G. Endoscopic endonasal surgery for resection of giant craniopharyngioma in a toddler—multimodal presurgical planning, surgical technique, and management of complications: 2-dimensional operative video. Oper Neurosurg (Hagerstown) 2020; 19 (01) E68-E69
    CrossrefPubMedSuche in Google Scholar
  • 2 Abul-Hassan HS, von Drasek Ascher G, Acland RD. Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg 1986; 77 (01) 17-28
    PubMedSuche in Google Scholar
  • 3 Fortes FSG, Carrau RL, Snyderman CH. et al. Transpterygoid transposition of a temporoparietal fascia flap: a new method for skull base reconstruction after endoscopic expanded endonasal approaches. Laryngoscope 2007; 117 (06) 970-976
    CrossrefPubMedSuche in Google Scholar
  • 4 Idriceanu T, Hudelist B, Moya-Plana A, Bresson D. How I do it: epidural transposition of the temporoparietal fascia flap for anterior skull base reconstruction. Acta Neurochir (Wien) 2023; 165 (08) 2327-2331
    CrossrefPubMedSuche in Google Scholar
  • 5 Siu A, Rangarajan SV, Rabinowitz MR. et al. Quantitative determination of the optimal temporoparietal fascia flap necessary to repair skull-base defects. Int Forum Allergy Rhinol 2020; 10 (11) 1249-1254
    CrossrefPubMedSuche in Google Scholar
  • 6 Sun X, Liu Q, Yu H. et al. Transinfratemporal fossa transposition of the temporalis muscle flap for skull base reconstruction after endoscopic expanded nasopharyngectomy: anatomical study and clinical application. J Neurol Surg B Skull Base 2021; 83 (02) 159-166
    Thieme ConnectPubMedSuche in Google Scholar