Use of free composite graft for a large defect in the anterior skull base

Until recently, most skull base tumors, particularly those extending into the orbit or anterior or middle cranial fossa base, were excised incompletely because of the technical difficulty in performing en bloc resections. However, improved craniofacial surgical techniques, recent developments in technology and equipment, improved imaging techniques, interdisciplinary collaboration, and improved anesthetic techniques have enabled a wide range of attempts resulting in successful clinical outcome. We present a case of recurrent meningioma with intracranial and extracranial extension in which three previous operations left a large craniectomy defect in the frontal area as well as a frontal lobe defect. After removal of the tumor, we reconstructed the large defect using composite graft (free bone and fascia lata).