A Comprehensive Algorithm for Anterior Skull Base Reconstruction after Oncological Resections

• DOI: 10.1055/s-2006-959333
• Publication Date: 2007-02-02T19:23:11Z
• Authors: Ziv Gil; Avraham Abergel; Leonor Leider-Trejo; Avi Khafif; Nevo Margalit; Aharon Amir; Eyal Gur; Dan Fliss
• Keywords: Fascia lata; Sinus (botany); Frontal sinus; Pneumocephalus

Objective: To present our method for anterior skull base reconstruction after oncological resections. Methods: One hundred nine patients who had undergone 120 resections of tumors (52 malignant [43%], 68 benign [57%]) via the subcranial approach were studied. Limited dural defects closed primarily or reconstructed using a temporalis fascia. Large by double-layer fascia lata graft. A split calvarial bone graft, posterior frontal sinus wall, three-dimensional titanium mesh used when tumor involved frontal, nasal, orbital bones. muscle flap was to cover socket cases eye globe exenteration, and rectus abdominis free subcranial-orbitomaxillary resection. Pericranial wrapping frontonaso-orbital segment performed prevent osteoradionecrosis if perioperative radiotherapy planned. Results: The incidence cerebrospinal fluid (CSF) leak, intracranial infection, tension pneumocephalus 5%. Histopathological immunohistochemical analysis grafts in reoperated (n = 7) revealed integration vascularized fibrous tissue graft local proliferation newly formed vascular layer embedding fascial sheath. Conclusion: alone adequate preventing CSF meningitis, pneumocephalus, brain herniation. We describe simple effective both tumors.