Skull Base Reconstruction after Oncologic Resections

Abstract

Material and Methods: In 109 patients, 120 anterior skull base resections of tumors (52 malignant [43%], 68 benign [57%]) via the subcranial approach were performed. Limited dural defects were closed primarily or reconstructed using a temporalis fascia. Large anterior skull base defects were reconstructed by a double-layer fascia lata graft. A split calvarial bone graft, posterior frontal sinus wall, or 3D titanium mesh was used when the tumor involved the frontal, nasal, or orbital bones respectively. A temporalis muscle flap was used to cover the orbital socket for cases of eye globe exenteration, and a rectus abdominis free flap was used for subcranial-orbitomaxillary resection. Pericranial flap wrapping of the frontonasal-orbital segment was performed to prevent osteoradionecrosis if perioperative radiotherapy was planned.