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Infant Nasoseptal Flap Skull Base Reconstruction in a Resource-Limited Setting in Ghana
Catherine Gbekie1, Matthew Ryan2, Kafui Searyoh3
1Columbia University Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
World Neurosurgery
|August 10, 2026
Summary
This study demonstrates a novel surgical technique for skull base reconstruction using the pedicled nasoseptal flap (NSF) in an infant. The procedure, performed with basic instrumentation in a low-resource setting, successfully treated a congenital meningoencephalocele and CSF leak.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Skull Base Reconstruction
Background:
- The pedicled nasoseptal flap (NSF) is a transformative technique for anterior skull base reconstruction.
- Its application in infants and young children, especially in low-resource settings, is not well-documented.
Purpose of the Study:
- To present a surgical technique for NSF reconstruction in an infant with a congenital anterior cranial fossa meningoencephalocele and cerebrospinal fluid (CSF) leak.
- To highlight the feasibility of this procedure in a low-resource setting.
Main Methods:
- A surgical technique using simple instrumentation for NSF reconstruction was employed.
- The procedure was performed on an infant in Accra, Ghana, to address a congenital meningoencephalocele and CSF leak.
Main Results:
- The surgery was successful, with an uneventful postoperative course.
- Follow-up confirmed no cerebrospinal fluid (CSF) leak or surgical complications.
- The patient received care at Korle-Bu Teaching Hospital in Accra, Ghana.
Conclusions:
- A safe and effective NSF skull base reconstruction technique using basic instrumentation is presented for carefully selected young infants in resource-limited environments.
- This represents the first reported case of such a procedure in Africa.
