Extended Pericranial Flap for Anterolateral Skull Base Reconstruction after Frontotemporal Orbitozygomatic Transcavernous Approaches: Operative Technique and Nuances

Abstract

Introduction: Technical advances in neurosurgery over the past several decades have allowed for the safe resection of deep and invasive skull base lesions previously deemed inoperable. Frontotemporal orbitozygomatic approaches are useful for resecting parasellar and cavernous sinus lesions. Meningiomas and other dural-based lesions arising from this region often require extensive dural resection and bone removal leading to a significant risk for cerebrospinal fluid leakage. Pericranial flap reconstruction has become a popular method for reconstructing skull base defects due to its autologous nature, ease of harvesting, and natural vascular pedicle. However, the lateral extent of the pericranium ends at the superior temporal line (STL) and the surface area is somewhat limited when using a frontotemporal curvilinear incision.