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212144

Reconstruction of a large anterior skull base defect with a multilayer graft augmented by a vascularized flap: A technical note

Article

Last updated: 24 Dec 2024

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Abstract

Skull base reconstruction of the anterior cranial fossa after the excision of large sinonasal or skull base tumors is still a challenge. The local flaps may be not available or insufficient to seal the whole defect. Harvesting regional flaps or free flap is a time-consuming procedure that may increase postoperative morbidity. We report a technique for reconstruction of anterior skull base using autologous grafts covered by free mucosal graft that is augmented by vascularized flaps in 2 cases. A 51 years old female patient with olfactory neuroblastoma underwent endonasal endoscopic resection followed by multilayer reconstruction using 3 layers of fascia lata sandwiched between a mucosal graft from above and double middle turbinate flaps from below. The second case was 48 years old male patient with non-intestinal type adenocarcinoma invading the anterior skull base. The resection of the tumor was done endoscopically and 3 layers of fascia lata were utilized and covered by a mucosal graft from above and the nasoseptal flap from below for reconstruction. No postoperative CSF leak was reported in either case. The graft augmented flap technique was effective that prevent postoperative morbidity.
 

DOI

10.21608/ejnso.2021.212144

Keywords

Reconstruction, Skull base, Tumors, Adenocarcinoma

Authors

First Name

Ahmed

Last Name

Monib

MiddleName

Hamed

Affiliation

Department of ORL – HNS, Assiut University, Faculty of Medicine, Assiut, Egypt

Email

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City

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Orcid

-

First Name

Ahmed

Last Name

Ibrahim

MiddleName

Ali

Affiliation

Department of ORL– HNS, Alexandria University, Faculty of Medicine, Alexandria, Egypt.

Email

ahmedaly284@gmail.com

City

-

Orcid

-

First Name

Aly

Last Name

Abd el-Hakeem

MiddleName

Ragaae

Affiliation

Department of OR– HNS, Assiut University, Faculty of Medicine, Assiut, Egypt

Email

-

City

-

Orcid

-

First Name

Ahmed

Last Name

Sholkamy Diab

MiddleName

Gamal

Affiliation

Department of ORL– HNS, Assiut University, Faculty of Medicine, Assiut, Egypt

Email

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City

-

Orcid

-

First Name

Mohammed

Last Name

Ragaae

MiddleName

Aly

Affiliation

Department of Neurosurgery, Assiut University, Faculty of Medicine, Assiut, Egypt.

Email

-

City

-

Orcid

-

Volume

7

Article Issue

3

Related Issue

24888

Issue Date

2021-12-01

Receive Date

2021-10-01

Publish Date

2021-12-01

Page Start

1

Page End

8

Print ISSN

2314-890X

Online ISSN

2314-8918

Link

https://ejnso.journals.ekb.eg/article_212144.html

Detail API

https://ejnso.journals.ekb.eg/service?article_code=212144

Order

1

Type

Original Article

Type Code

1,045

Publication Type

Journal

Publication Title

Egyptian Journal of Neck Surgery and Otorhinolaryngology

Publication Link

https://ejnso.journals.ekb.eg/

MainTitle

Reconstruction of a large anterior skull base defect with a multilayer graft augmented by a vascularized flap: A technical note

Details

Type

Article

Created At

22 Jan 2023