Anterior Cranial Base Reconstruction

Abstract

Carl Snyderman, MD, and collaborators at the University of Pittsburgh, recently reported their experience with reconstruction of the anterior skull base at the Eastern Section meeting of the Triological Society in New York City. They presented 25 cases in which the communication between the cranial cavity and the nose and nasopharynx was closed utilizing an arterialized galeopericranial flap. This flap is based on blood supply from the superficial temporal, supraorbital, and supratrochlear arteries, bilaterally in most cases. It is particularly useful in cases where poor wound healing is expected, or where the dura has been violated and repaired. Another advantage is the rapid healing provided, allowing early institution of radiation therapy. The flap provided primary healing in all cases, with no cases of meningitis and three cases with cerebrospinal fluid leaks. The disadvantages of this flap are loss of frontalis muscle function, anesthesia of the forehead, possible hair loss, more