Anterior Skull Base Reconstruction With a Galeal-Pericranial Flap

2007 ◽  
Vol 18 (3) ◽  
pp. 622-625 ◽  
Author(s):  
Enrico Nastro Siniscalchi ◽  
Filippo Flavio Angileri ◽  
Paola Mastellone ◽  
Luciano Catalfamo ◽  
Maria Giusa ◽  
...  
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Skull Base Reconstruction ◽  
Pericranial Flap

Pericranial Flap for Endoscopic Anterior Skull-Base Reconstruction

Neurosurgery ◽  
2010 ◽  
Vol 66 (3) ◽  
pp. 506-512 ◽  
Author(s):  
Mihir R. Patel ◽  
Rupali N. Shah ◽  
Carl H. Snyderman ◽  
Ricardo L. Carrau ◽  
Anand V. Germanwala ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Preoperative Planning ◽  
Cranial Base ◽  
Anterior Skull Base ◽  
Dural Defect ◽  
Skull Base Reconstruction ◽  
Pericranial Flap ◽  
Endonasal Reconstruction ◽  
Ventral Skull Base

Abstract BACKGROUND One of the major challenges of cranial base surgery is reconstruction of the dural defect and prevention of postoperative cerebrospinal fluid (CSF) fistula. The introduction of endoscopic techniques and an endonasal approach to the ventral skull base has created new challenges for reconstruction. OBJECTIVE We have developed an endoscopic pericranial flap (PCF) for skull base reconstruction and hereby present the initial cohort of patients who had endonasal reconstruction with a PCF after endoscopic skull base resection. We also demonstrate a method to radiographically incorporate anticipated skull base defects for preoperative planning of PCF length. METHODS Dural defects after endonasal skull base resection of invasive tumors were reconstructed with an onlay PCF (n = 10). We performed radiological studies to assist preoperative planning for where to make incisions while harvesting a PCF for anterior skull base, sellar, and clival defects. RESULTS Each of the 10 patients had excellent healing of their skull base and had no evidence of any postoperative cerebrospinal fluid leaks. Eight patients had radiation therapy without flap complications. Radiographic studies demonstrate that the adequate PCF length, covering defects of the anterior skull base, sellar, and clival defects are 11.31 to 12.44 cm, 14.31 to 15.57 cm, and 18.5 to 20.42 cm, respectively. CONCLUSION The PCF provides an option for endonasal reconstruction of cranial base defects and can be harvested endoscopically. Pre-operative radiographic evaluation may guide surgical planning. There is minimal donor site morbidity, and the flap provides enough surface area to cover the entire ventral skull base.

Vascularized Pericranial Flap for Endonasal Anterior Skull Base Reconstruction

2021 ◽  
Author(s):  
Jonathan Giurintano ◽  
Michael W. McDermott ◽  
Ivan H. El-Sayed
Keyword(s):  
Minimally Invasive ◽  
Skull Base ◽  
San Francisco ◽  
Middle Turbinate ◽  
Cranial Base ◽  
Anterior Skull Base ◽  
Craniofacial Resection ◽  
Skull Base Reconstruction ◽  
Pericranial Flap ◽  
Anterior Cranial Base

Abstract Importance As the limits of advanced skull base malignancies that can be managed through an endoscopic endonasal approach continue to be expanded, the resultant anterior skull base defects are of increasing size and complexity. In the absence of nasoseptal or turbinate flaps, the vascularized pericranial flap has been employed at our institution with excellent results. Objective The study aimed to review the outcomes of patients who underwent endonasal anterior craniofacial resection with anterior skull base reconstruction using a vascularized pericranial flap. Design Retrospective chart review of patients treated by the University of California – San Francisco minimally invasive skull base service from the years 2011 to 2017. Average duration of follow-up was 16.4 months. Setting This study was conducted at Academic tertiary referral center. Participants A total of nine patients with advanced anterior cranial base malignancies were identified who were treated with a minimally invasive, endoscopic anterior craniofacial resection from the years 2011 to 2017. Due to the nature of the resection in these patients, nasoseptal flaps and inferior/middle turbinate flaps were unavailable or insufficient for anterior skull base defect repair. Each patient underwent reconstruction of the anterior cranial base defect using an anteriorly based pericranial flap harvested by bicoronal incision, and tunneled anteriorly to the nasal cavity through a frontoethmoidal incision.

Pericranial Flap for Endoscopic Anterior Skull Base Reconstruction: Clinical Outcomes and Radioanatomic Analysis of Preoperative Planning

Skull Base ◽  
2009 ◽  
Vol 19 (03) ◽  
Author(s):  
Mihir Patel ◽  
Rupali Shah ◽  
Carl Snyderman ◽  
Ricardo Carrau ◽  
Anand Germanwala ◽  
...  
Keyword(s):  
Skull Base ◽  
Clinical Outcomes ◽  
Preoperative Planning ◽  
Anterior Skull Base ◽  
Skull Base Reconstruction ◽  
Pericranial Flap

Pericranial Flap Anterior Skull Base Reconstruction With Gelfoam Intradural Compression

2019 ◽  
Vol 30 (4) ◽  
pp. 1280-1283
Author(s):  
Tae-wook Song ◽  
Seul-kee Lee ◽  
Tae-Sun Kim ◽  
Sung-Pil Joo
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Skull Base Reconstruction ◽  
Pericranial Flap

Hidden Port Approach to Endoscopic Pericranial Scalp Flap for Anterior Skull Base Reconstruction

2021 ◽  
Author(s):  
Alfredo García‐Fernández ◽  
Esther García‐González ◽  
Igor Paredes‐Sansinenea ◽  
Víctor Rodríguez‐Berrocal ◽  
José Fernández‐Alén ◽  
...  
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Skull Base Reconstruction ◽  
Scalp Flap
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