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Vascularized Flaps for Anterior Skull Base Defects
Lacy Brame1, Aniruddha Parikh2, Kibwei McKinney3
1Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA.
Otolaryngologic Clinics of North America
|March 14, 2026
Summary
Vascularized flaps are the gold standard for skull base reconstruction, particularly for cerebrospinal fluid leaks. The nasoseptal flap is most common, but alternatives exist if it is unavailable.
Area of Science:
- Neurosurgery
- Otolaryngology
- Plastic Surgery
Background:
- Skull base defects require specialized reconstruction techniques.
- Cerebrospinal fluid (CSF) leaks necessitate robust closure methods.
- Vascularized flaps are considered the gold standard for complex reconstructions.
Purpose of the Study:
- To review techniques for skull base defect reconstruction.
- To highlight the role of vascularized flaps, especially for CSF leaks.
- To discuss alternative flap options when the primary choice is unavailable.
Main Methods:
- Literature review of skull base reconstruction techniques.
- Focus on vascularized flaps, including the nasoseptal flap.
- Comparison of alternative flap options.
Main Results:
- Vascularized flaps are the preferred method for skull base reconstruction.
- The nasoseptal flap is frequently used due to its efficacy and ease of harvest.
- Several alternative flaps (inferior turbinate, middle turbinate, lateral wall, pericranial, temporoparietal fascia) can be employed.
Conclusions:
- Vascularized flaps are essential for successful skull base reconstruction.
- The nasoseptal flap is a versatile and reliable option.
- Availability of multiple flap options ensures successful reconstruction even when the nasoseptal flap cannot be used.
