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Updated: Jun 12, 2026
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Anterior skull base reconstruction: a review of current techniques
Cecelia E Schmalbach1, David E Webb, Erik K Weitzel
1Department of Otolaryngology, Wilford Hall Medical Center, Lackland AFB, Texas, USA. Cecelia.Schmalbach@lackland.af.mil
Purpose Of Review:
The purpose of this review is to discuss current reconstructive options in anterior skull base reconstruction.
Recent Findings:
Free tissue transfer has superseded regional myocutaneous flaps in the reconstruction of large anterior skull base defects. Local flaps remain the mainstay for smaller defects. A host of nonautologous biomaterials are also used in the setting of small-to-moderate-sized defects requiring rigid support. They should not be used in the setting of radiation owing to the high extrusion rate. Lastly, the advent of endoscopic tumor resection has introduced a variety of local flaps amenable to endoscopic reconstruction.
Summary:
The last decade has experienced a growth in anterior skull base reconstructive options owing to improvements in microvascular technique, endoscopic equipment, image guidance, and biomaterials. As a result, the choices in reconstructive technique have expanded, allowing for more radical tumor extirpations.
