A Novel Modification of the Island Palatal Flap based on Radiologic and Cadaveric Investigations which Allows for Pedicled Reconstruction of the Skull Base

Abstract

Introduction: Endoscopic reconstruction of large skull base defects is a challenge. Reconstruction with vascularized tissue facilitates healing and decreases the rates of postoperative cerebrospinal fluid (CSF) leaks. The posteriorly pedicled nasoseptal flap is our primary reconstructive option; however, prior surgery may disrupt its blood supply. We focused on branches of the internal maxillary artery as potential pedicles for alternate vascularized reconstructive tissue.