A Visual Introduction to the Adaptation of the Pedicled Flap in Endoscopic Reconstruction of Cranial Base

The transsphenoidal approach provides a well-established route for ventral skull base surgery and in particular intrasellar pathology. The use of the vascular pedicled flap has effectively countered the complications previously associated with the bone and dural defect produced by this procedure. The purpose of this article is to introduce the various steps of this technique from a surgical perspective with the addition of an interactive video.

Videos and still images obtained from 100 different endonasal endoscopic transsphenoidal procedures, for standard sella pathology and an expanded approach for parasellar and anterior fossa tumors, were used and edited to create step-by-step interactive videos of surgical approach and its surgical nuances.

Teaching of endoscopic techniques is challenging, and simulation models are not readily available at most institutions.

We believe the implementation of this video provides greater insight to the technique and provides an invaluable education tool for residents, fellows, and neurosurgeons who wish to acquire this technique and approach.