Expert Strategies: Skull Base Reconstruction—Global Perspectives, Insights, and Algorithms through a Mixed Methods Approach

• DOI: 10.1002/alr.23596
• Publication Date: 2025-05-15T10:29:32Z
• Authors: Edward C. Kuan; Vidit Talati; Jagatkumar A. Patel; Theodore V. Nguyen; Arash Abiri; Jonathan C. Pang; Khodayar Goshtasbi; Lauren Liu; John R. Craig; Peter Papagiannop...; Katie M. Phillips; Bobby A. Tajudeen; Nithin D. Adappa; James N. Palmer; Ahmad R. Sedaghat; Eric W. Wang; Vijay Anand; Pete S. Batra; Marvin Bergsneider; Manuel Bernal‐Spr...; Benjamin S. Bleier; Paolo Cappabianca; Ricardo L. Carrau; Roy R. Casiano; Paolo Castelnuovo; Luigi M. Cavallo; Marc A. Cohen; Iacopo Dallan; Jean Anderson Eloy; Ivan H. El‐Sayed; James J. Evans; Juan C. Fernandez...; Marco Ferrari; Sebastien Froelich; Paul A. Gardner; Christos Georgalas; Stacey T. Gray; Ehab Y. Hanna; Richard J. Harvey; Sang Duk Hong; Peter H. Hwang; Daniel F. Kelly; Doo‐Sik Kong; Ming‐Ying Lan; John Y. K. Lee; Corinna G. Levine; James K. Liu; Davide Locatelli; Cem Meço; Erin L. McKean; Piero Nicolai; Gurston G. Nyquist; Kazuhiro Omura; Thibault Passeri; Zara M. Patel; Maria Peris Celda; Carlos Pinheiro Neto; Danny M. Prevedello; Mindy R. Rabinowitz; Shaan M. Raza; Pablo F. Recinos; Marc R. Rosen; Zoukaa B. Sargi; Rodney J. Schlosser; Theodore H. Schwartz; Raj Sindwani; Carl H. Snyderman; Aldo C. Stamm; Brian D. Thorp; Mario Turri‐Zanoni; Marilene B. Wang; Wei‐Hsin Wang; Ian J. Witterick; Tae‐Bin Won; Bradford A. Woodw...; Peter‐John Wormald; Gabriel Zada; Shirley Y. Su

ABSTRACT Objective There is limited consensus on endoscopic skull base surgery (ESBS) reconstruction principles. This study aims to generate comprehensive themes regarding ESBS by pooling the experiences of experts, with comparison a literature review current published evidence. Methods Structured qualitative interviews experts postoperative management and various defect locations were conducted. Results A total 68 comprising 40 academic teams across 13 countries an average 18 years experience included. We propose 10 stepwise algorithms for common scenarios based these expert interviews. When available, nasoseptal flap used all high_flow cerebrospinal leak defects. Multilayered favored at anatomical subsites increasing number layers size complexity. Heterogeneity exists in terms inlay technique materials, free grafting versus pedicled options low‐flow defects or absence nasal septum, packing, tissue sealant, lumbar drain use, management. Commonalities discrepancies between summarized. Conclusion Skull post‐ESBS highly complex wide variety practice patterns strategies. Further research higher quality evidence warranted identify optimal patterns, though work inform surgeons controversial areas drawing from numerous experiences.