Abstract
Background As the scope of endoscopic techniques continues to evolve in the treatment of advanced
sinonasal malignancies, the primary challenge is the reconstruction of the resulting
anterior skull base dural defect.
Objective This study aimed to assess the efficacy of vascularized pericranial flap reconstruction
in addressing anterior skull base defects in sinonasal malignancies, particularly
when alternative reconstructive methods, such as nasoseptal flaps, are not viable.
Methods We conducted a retrospective review of nine patients who underwent endoscopic resection
of sinonasal malignancy followed by vascularized pericranial flap. Our analysis aimed
to evaluate the surgical methods utilized, identify any complications that occurred,
and assess the postoperative results of the patients.
Results Excluding the singular instance of tension pneumocephalus that emerged during the
immediate postoperative period, necessitating surgical intervention, our clinical
experience was devoid of any complications, with a median follow-up duration of 18
months. It is worth noting that no cases of cerebrospinal fluid leaks or meningitis
were reported. Moreover, the follow-up check endoscopy verified the successful integration
of the flap and its efficacious coverage of the resection site.
Conclusion This study underscores the benefits of using vascularized pericranial flaps as an
alternative solution for anterior skull base reconstruction in sinonasal malignancies.
The availability of the pericranial flap in the local region, along with its robust
blood supply, and the positive outcomes observed in this preliminary series collectively
indicate its potential as an integral component of multi-layered reconstruction techniques
for addressing anterior skull base defects.
Keywords
anterior skull base - sinonasal malignancies - pericranial flap
