How we do it: mini posterior septal artery flap for coverage after transphenoidal approaches

We propose a novel posterior nasal flap for use in endoscopic approaches to the sella and parasellar region that involve resection of the sphenoid face and a posterior nasal septectomy. It involves elevation of the mucosa of the posterior septum and sphenoid face with preservation of the angiosome based on the posterior septal artery. This flap has the advantages of maximal mucosal preservation in order to optimize postoperative healing and has been demonstrated to permit future elevation of a complete naso-septal flap for reconstruction of anterior skull base defects. An illustration of the technique is provided.