Transfrontal Endonasal Reconstruction of Anterior Skull Base with Pericranial Flap without Craniotomy: Technical Note

Background The resection of tumors of the ventral skull base brings great technical challenges, among which, the reconstruction of the anatomic defect postsurgical. Endonasal endoscopic techniques provide a new perspective for the repair of these defects with the use of synthetic dura mater, and vascularized patches such as nasoseptal and pericranial flaps. This article reports our experience in the endoscopic reconstruction of advanced nasal tumors with the use of pericranial flap.

Clinical Presentation This is a descriptive study of four cases of advanced nasal cavity tumors submitted to complete endonasal endoscopic resection and pericranial flap reconstruction. There were three males and one female patients, and the main complaint for service was nasal obstruction in all patients. The histological types found were adenocarcinoma (in two cases), esthesioneuroblastoma, and epidermoid carcinoma. All patients presented advanced stage of diagnosis (T4N0M0), two of whom had a dura mater, but no intracranial invasion. The patients were submitted to exclusive endoscopic resection, with acquisition of free margins in the intraoperative frozen section. After complete resection, the galeal flap was nourished by the supraorbital and supratrochlear arteries to close the dural defect.

Conclusion Surgical results are promising regarding the applicability of the surgical technique, low complication rate, and postoperative recovery.

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Publication History

Publication Date:
02 February 2018 (online)