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Published on: July 5, 2021
How I do it: exoscopic minimally invasive pericranial flap harvest for endoscopic anterior skull base reconstruction
Markus K H Wiedmann1, Johan Edvard Steineger2, Daniel Dahlberg3
1Department of Neurosurgery, Oslo University Hospital, Sognsvannsveien 20, 0372, Oslo, Norway. Markus.kh.wiedmann@gmail.com.
Background:
The pericranial flap is a reliable option for reconstructing the anterior skull base in extended endoscopic endonasal procedures when the nasoseptal flap is unavailable or insufficient.
Methods:
We describe a minimally invasive and fast technique for harvesting a vascularized pericranial flap using a three-dimensional exoscope through a small frontal incision, with simultaneous endoscopic endonasal placement, for anterior skull base reconstruction.
Conclusion:
Exoscope-assisted pericranial flap harvest provides excellent visualization, ergonomics, and flap control, enabling reliable orbit-to-orbit coverage of large anterior skull base defects with low donor-site morbidity when intranasal vascularized options are limited.
