Related Experiment Video
Updated: Jun 18, 2026
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
How I do it - exoscopic retractorless anterior skull base reconstruction using a pedicled pericranial flap for
Michael Veldeman1, Mark Johannes Marinus Houmes2, Hans Clusmann2
1Department of Neurosurgery, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany. mveldeman@ukaachen.de.
Background:
Traumatic anterior cranial fossa fractures complicated by cerebrospinal fluid (CSF) fistulas carry the risk of ascending meningitis.
Method:
We describe our standardised technique for anterior cranial fossa repair via a bifrontal craniotomy, including preparation of a pericranial flap, closure of the frontal sinus, bilateral olfactory nerve dissection, and intradural pericranial reconstruction.
Conclusion:
A systematic, anatomically informed approach enables durable watertight repair with acceptable morbidity. If surgery is properly timed after cerebral swelling has resolved, and CSF is drained, retractorless surgery prevents injury to the inferior face of the frontal lobes.
