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

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.

Publication History

Received: 17 June 2025

Accepted: 13 October 2025

Accepted Manuscript online:
17 October 2025

Article published online:
31 October 2025

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