Abstract
Background: The transpterygoid approach to the skull base traditionally indicates sacrifice of the sphenopalatine artery however, this eliminates the option to harvest an ipsilateral nasoseptal flap (NSF) for reconstruction, which is based off the posterior septal branch of the sphenopalatine artery. In cases where other reconstructive options are limited, it may be necessary to utilize a NSF ipsilateral to the transpterygoid approach. Here we describe the technique of NSF pedicle preservation through careful dissection and mobilization, as well as present a case series with reconstruction outcomes.
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