Skull Base 2007; 17(1): 073-078
DOI: 10.1055/s-2006-959337
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Endoscopic Reconstruction of Cranial Base Defects following Endonasal Skull Base Surgery

Carl H. Snyderman1 , Amin B. Kassam2 , Ricardo Carrau1 , Arlan Mintz2
  • 1Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • 2Department of Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Further Information

Publication History

Publication Date:
08 January 2007 (online)

ABSTRACT

The expanded endonasal approach provides access to the entire ventral skull base for resection of neoplasms involving the skull base and brain. The creation of large defects of the bone and dura endoscopically presents unique reconstructive challenges. A layered reconstruction of the dura with inlay and onlay fascial grafts covered with fat grafts is an effective technique for repair. An intranasal balloon catheter is used to provide counterpressure in the early phase of healing and a lumbar spinal drain is a useful adjunct in patients at increased risk of a cerebrospinal fluid leak. Vascularized flaps may be necessary in some patients receiving radiation therapy. Continued advances in surgical technology and the introduction of new biomaterials will facilitate the reconstruction of skull base defects following endonasal brain surgery.

REFERENCES

Carl H SnydermanM.D. 

Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh School of Medicine, Eye and Ear Institute

Ste. 500, 200 Lothrop St., Pittsburgh, PA 15213

Email: snydermanch@upmc.edu