Abstract
With an increased understanding of the pathological processes involved in perinerual
spread, surgery has come to play a greater role in its management. As skull base techniques
have been refined, the reconstructive surgeon has been presented with increasingly
complex and voluminous defects requiring repair. To enable such surgery to have acceptable
outcomes, attention to form and function is paramount. This article describes the
methods of repair, which have evolved over the last 25 years of practice, and that
we find to be both reliable and durable. Our accumulated experience is presented as
a treatment algorithm, which will aid the skull base reconstructive surgeon to achieve
success for the wide variety of defects encountered with these patients.
Keywords
skull base defect - perineural spread - skull base malignancy - free flap reconstruction
- cerebrospinal fluid leak
