Turbinate Flap Research Articles

Nasoseptal Flap Reuse for Reconstruction in Revision Endoscopic Skull Base Surgery

Abstract Introduction The nasoseptal flap (NSF) is the “workhorse” for reconstruction in endoscopic skull base surgery. It creates a reliable, watertight closure to prevent cerebrospinal fluid (CSF) leaks. The flap's robust vascular pedicle allows for it to be taken down and reused in subsequent reconstructive surgeries if needed. Previous literature has demonstrated successful reuse of the flap up to 24 months after initial surgery. The present study analyzes a cohort of patients with NSFs that were reused up to 12 years following the initial surgery. Methods A retrospective analysis was performed on patients who underwent revision endoscopic skull base surgery for recurrent tumor at a tertiary academic skull base center. Patient demographics, tumor type, length of time between first and second surgery, and outcomes were evaluated. Results A total of 15 patients were identified between 2012 and 2022 who underwent revision endoscopic skull base surgery with previous NSFs that were reused for reconstruction. The time interval between surgeries ranged from 9 months to 12 years. There were 12 pituitary adenomas, 2 Rathke's cleft cysts, and 1 craniopharyngioma. One patient developed a CSF leak 5 days postoperatively, which was repaired with an abdominal fat graft, synthetic dural substitute, and a middle turbinate flap. The operative technique for the take-down and reuse of the NSF will be demonstrated. Conclusion The NSF can be taken down and reused in revision endoscopic skull base cases, even several years after the initial surgery, with excellent coverage of the defect and low incidence of postoperative CSF leak.

A Case of Oronasal Fistula Repaired With Inferior Turbinate Rotational Flap

Oronasal fistula is a rare but significant complication that diminishes the quality of life for patients undergoing treatment for cleft palate and head and neck cancer. Various surgical reconstruction methods can be used based on the size and location of the oronasal fistula. The intranasal inferior turbinate rotational flap is a simple and safe method for reconstructing the defect of nasal cavity. In this case report, we experienced a small oronasal fistula of a 50-year-old female caused by osteoradionecrosis after treatment for her malignant melanoma. Successful reconstruction was achieved with inferior turbinate rotational flap alone. For small oronasal fistula in the hard palate, the inferior turbinate flap alone can be a useful option for reconstruction.

Reconstruction of Anterior Skull Base After Cleaver Trauma: Combined Use of Fascia Lata and Middle Turbinate Flap in a Patient with Concha Bullosa.

This video article presents a 47-year-old male patient who presented to the emergency department after a cleaver bounced off the grinding wheel and lodged between his eyebrows. The patient complained of clear nasal drainage since the trauma. Computed tomography showed a comminuted displaced fracture starting from the right frontonasal recess and extending along the right ethmoid roof. The patient underwent surgery. The skull base defect was reconstructed with a free fascia lata graft in the first operation. In the second session, the reconstruction of the skull base was reinforced with a flap that was prepared from the middle turbinate with the concha bullosa. The patient was followed for eight months. The patient's symptoms resolved completely and there was no evidence of rhinorrhoea or any other complication at the control examination. No complications were seen on control magnetic resonance imaging.

Management Strategy of a Grade-3 Cerebrospinal Fluid Leak Repair Following Endoscopic Endonasal Transsphenoidal Excision of Pituitary Macroadenoma.

A skull- base defect with grade-3 cerebrospinal fluid (CSF) leak following a pituitary macroadenoma removal is rare and challenging. We provide a simple sample model of multilayer closure with naturally available hard and soft tissue components. Tamponade was provided to the reconstructed site with a simple inflated Foley's catheter bulb. There was no repair failure and cavities were well mucosalised on follow-up. Mucosal and turbinate preservation was fully achieved in this method as no turbinate flaps were raised or large raw surface exposure was there.

The Temporoparietal Fascia Flap Transposition Technique for Ventral Skull Base Reconstruction: Anatomic Analysis and Surgical Application.

The temporoparietal fascia (TPF) flap is an alternative for revision endoscopic skull base reconstruction in the absence of the nasoseptal flap, and we aimed to investigate the anatomy and surgical application of TPF flap transposition in endoscopic endonasal surgery. Six lightly embalmed postmortem human heads and 30 computed tomography angiography imaging scans were used to analyze the anatomic features of the TPF flap transposition technique. Three cases selected from a 512 endoscopic endonasal cases database were presented for the clinical application of the TPF flap. The TPF flap, composed by the deepest 3 scalp layers (galea aponeurotica, loose areolar connective tissue, and pericranium), can be harvested and then transposed through the infratemporal-maxillary-pterygoid tunnel to the ventral skull base. The superficial temporal artery as its feeding artery, gives frontal and parietal branches with similar diameter (1.5 ± 0.3 mm) at its bifurcation. The typical bifurcation was present in 50 sides (83.3%), with single (frontal) branch in 5 sides (8.3%), single (parietal) branch in 2 sides (3.3%), and multiple branches (>2) in 3 sides (5%). The transposed TPF flap was divided into 3 parts according to its anatomic location: (1) infratemporal part with an area of 19.5 ± 2.5 cm2, (2) maxillary part with an area of 23.7 ± 2.8 cm2, and (3) skull base part with an area of 44.2 ± 4 cm2. Compared with the nasoseptal flap, nasal floor flap, inferior turbinate flap, and extended septal flap, the coverage area of the skull base part of the TPF flap was significantly larger than any of them (P < .0001). The TPF flap technique is an effective alternative for endoscopic endonasal skull base reconstruction. The TPF flap could successfully cover large skull base defects through the infratemporal-maxillary-pterygoid tunnel.

Modified Mucosal Reconstruction in Unilateral Complete Cleft of Lip and Primary Palate: Surgical Technique and Practical Strategies.

The nasal floor and intraoral lining reconstruction of unilateral complete cleft of lip and primary palate has sparsely been reported. Solution: This article combines the previously-described C-flap mucosal flap and inferior turbinate flap with the newly-described lateral nasal mucosal flap for the mucosal repair of this uncommon subtype of deformity. Valuable practical strategies are offered to optimize the surgical execution within a limited pediatric intranasal surgical access, targeting to minimize tissue trauma and bleeding.

Endoscopic Reconstruction of the Sellar Floor by Extended Inferior Turbinate Flap in Recurrent Pituitary Tumors.

Objective This aim of this study was to address the outcome of endoscopic reconstruction of the sellar floor by extended inferior turbinate flap. Patients and Methods This is a retrospective study of 34 patients with a recurrent pituitary tumor. They were treated between March 2018 and December 2021 by endoscopic extended endonasal approach with the reconstruction of the sellar floor by an extended posterior pedicle inferior turbinate flap. The clinical and radiological follow-up was performed immediately postoperation and regularly every 3 months up to 1 year, and the available data from the last follow-up visit were included in the analysis. Results The patients' age ranged between 40 and 65 years, with a slight female predominance (55.9%). Headache was the main presentation (47.1%), and functional tumors were found in 50.0% patients. Visual disturbances were field defects among 61.8% and papilledema among 52.9% patients. Preoperative endoscopy revealed postseptectomy as the significant finding (73.5%), followed by postseptectomy and adhesion (14.7%) and finally postseptectomy and hypertrophied inferior turbinate (11.8%). Total tumor resection was achieved in 76.5%, visual improvement was recorded in 52.9%, and no complications were reported in 82.4% patients. Cerebrospinal fluid (CSF) leak was not reported in any of the studied patients. Finally, total resection was significantly associated with younger age, non-functioning tumor and improvement of headache. Conclusion The extended inferior turbinate flap is an effective and safe approach for sellar floor reconstruction in endoscopic endonasal surgery for recurrent pituitary tumors. The extension overcomes the relatively small inferior flap and its limited arc of rotation.

Bilateral Inferior Turbinate Flaps for Salvage Reconstruction after Proton Beam Radiotherapy for Clival Chordoma.

Clival chordoma is a rare, aggressive, notochord-derived tumor primarily managed with surgery via an endoscopic endonasal approach (EEA) and adjuvant proton beam radiotherapy. Reconstruction is commonly performed with a nasoseptal flap (NSF) at the time of initial surgery. While failures of the NSF are rare, they can occur following the initial surgery or in the setting of osteoradionecrosis. Salvage repair typically requires transfer of alternative vascularized tissues outside of the previously radiated field including regional scalp flaps such as pericranial or temporoparietal fascial flaps, or free vascularized tissue transfer. Here we describe the case of a 29-year-old woman with a history of clival chordoma with widespread skull base osteomyelitis secondary to NSF necrosis after proton beam radiotherapy. We describe successful skull base reconstruction with intranasal bilateral inferior turbinate flaps based on the sphenopalatine artery with lateral nasal wall extension, despite prior proton beam therapy and a failed prior vascularized intranasal reconstruction.

Revision Skull Base Reconstruction Using Combined Inferior and Middle Turbinate Flap After Nasoseptal Flap Failure

When patients with a history of skull base reconstruction where nasoseptal flap was used require revision surgery, selecting an appropriate flap may be challenging. We report here a successful experience of using combined inferior and middle turbinate flap for revision skull base reconstruction after a nasoseptal flap failure at 22 days postoperatively. A 63-year-old female complaining of right vision loss was referred for co-operation. The patient had undergone transsphenoidal approach (TSA) resection for a pituitary adenoma 20 years ago. Sella turcica MRI showed a recurrent pituitary adenoma of 3.5×5.3-cm in size in the sellar and suprasellar areas, extending to the right cavernous sinus. Endoscopic extended TSA with nasoseptal flap reconstruction was performed for the patient. Flap necrosis followed and flap failure progressed after 10 postoperative days. The patient then underwent a skull base reconstruction using a vascularized inferior turbinate flap and a contralateral middle turbinate flap. Postoperatively, the revision flaps successfully covered the skull base defect without complications.

Nasal and Skull Base Reconstruction with Turbinate Flaps

Introduction: The reconstruction of the skull base and nasal mucosa can be performed using different local flaps. The use of the nasoseptal flap is the most common method to reconstruct these areas, but sometimes, due to septal perforations, a history of previous surgeries that may have damaged its pedicle, or because its rotational arc is not ideal, other nasal flaps such as those from the inferior or middle turbinate with their various pedicles may need to be employed. Objectives: The aim of this study was to ascertain the success rate of reconstructions involving the nasal cavity and skull base utilizing inferior and middle turbinate flaps. Methods: Data collected prospectively were analyzed using an Excel spreadsheet for patients who underwent skull base and nasal cavity defect repairs employing turbinate flaps between May 2014 and August 2021. Results: Nine patients were treated and a total of ten reconstructions were performed. Five middle turbinate flaps were executed, two involving medial rotation to address defects situated on the ethmoid roof and three involving lateral rotation to repair a defect within the ethmoid fovea, with two of these flaps closing the frontal ostium. Furthermore, an inferior turbinate flap with a posterior pedicle was utilized to repair the defect resulting from the resection of a meningocele, which was located on the ethmoid roof. Four lateral wall flaps with an anterior pedicle were employed to reconstruct the mucosa of the nasal cavity and to address a defect in the anterior skull base. Conclusion: The reconstruction of anterior skull base defects using turbinate flaps was highly satisfactory, achieving a 100% success rate. The use of lateral wall flaps to repair defects produced by rhinectomies that included resection of the nasal mucosa was also successful and we did not have partial or total necrosis of the flaps. The excellent blood supply to the lateral nasal walls and the ability to dissect these flaps with different arterial pedicles and extend their surface, including the nasal floor, allows for various flap rotations and the reconstruction of defects of different sizes.

Superiorly Based Middle Turbinate Flap for Repair of Cerebrospinal Fluid Rhinorrhea: A Cadaveric Feasibility Study and Case Series.

Objectives Cerebrospinal fluid (CSF) leaks of the anterior cranial base are frequently repaired with endonasal, multilayered reconstructions. Vascularized tissue flaps are superior to free mucosal grafts and biomaterials in many cases. Limitations of previously described flaps include reach, rotation, pedicle availability, and postoperative sinonasal morbidity. The objective of this study is to describe the superiorly based middle turbinate flap, a novel vascularized mucosal reconstruction option, and to present a case series demonstrating flap utility. Design Cadaveric feasibility study with technical description and illustrative case series. Setting Tertiary medical center. Participants Three silicone-injected cadaveric specimens (6 sides); 7 patients with CSF rhinorrhea from bony dehiscence of the anterior cranial fossa repaired with a superiorly based middle turbinate flap. Outcome Measures Cadaveric feasibility, in vivo repair outcomes, sinonasal symptoms, and postoperative healing. Results Cadaveric dissection demonstrated a consistent vascular plexus arising from the anterior and posterior ethmoid arteries, originating at the superior attachment of the middle turbinate and traveling inferiorly to supply the mucosa of the middle turbinate. Mean surface area of the flap was 776.67 ± 114.60 mm 2 . The clinical series of 7 patients involved leaks around the cribriform plate and fovea ethmoidalis. There were no instances of repair failure. All cases showed rapid and complete remucosalization without significant sinonasal morbidity. Conclusion The superiorly based middle turbinate flap is a reliable, versatile, and effective option for a vascularized mucosal flap onlay that can be used in anterior skull base reconstruction. This flap is particularly useful in the repair of defects involving the cribriform plate and fovea ethmoidalis.

Rare syringoid eccrine carcinoma of the upper lip and nasal base treated with resection and subsequent innovative reconstruction using an Abbé flap, turbinate flaps and three-stage forehead flap: a case report

BackgroundAlthough syringoma is a common benign tumour of the sudoriferous gland, there is also an extremely rare malignant form known as syringoid eccrine carcinoma (SEC). SEC usually exhibits slow growth with deep invasion and a frequent tendency to relapse. The treatment of choice is radical wide resection, which poses a difficult reconstructive problem, especially when the tumour is located in the centre of the face.Case presentationIn this case, a 70-year-old man was diagnosed with an SEC at the same location as a benign syringoma of the upper lip and nasal base that had undergone primary excision 7 years prior. Primary radical resection was performed with immediate Abbé flap reconstruction. Nevertheless, histology revealed positive margins, and 3 additional re-excisions were needed to achieve clear margins. Four months after the initial resection, the patient had undergone an innovative reconstruction technique including not only the Abbé flap but also a turbinate flap harvested with functional endonasal surgery and a three-stage forehead flap.ConclusionTo the best of our knowledge, this is the first case report of a suspect malignant transformation of a benign syringoma after 7 years. In addition, from oncoplastic and reconstructive points of view, the bilateral use of the turbinate flap for reconstructing the intranasal lining of the alar base is unusual, and the use of functional endonasal surgery in nasal reconstruction for reducing the risk of damaging the vascular supply of the flap is innovative.

The critical importance of a vascularized flap in preventing recurrence after endoscopic repair of spontaneous cerebrospinal fluid leaks and meningoencephaloceles.

Spontaneous CSF leaks into the anterior skull base nasal sinuses are often associated with meningoencephaloceles and occur in patients with idiopathic intracranial hypertension (IIH). Endonasal endoscopic repair has become the primary method of choice for repair. The authors sought to evaluate the success rate of endoscopic closure and to identify predictive factors for CSF leak recurrence. A consecutive series of endonasally repaired anterior skull base meningoencephaloceles was drawn from a prospectively acquired database. Lumbar punctures were not performed as part of a treatment algorithm. All patients had at least 5 months of follow-up. Chart review and phone calls were used to determine the timing and predictors of recurrence. Demographic information and details of operative technique were correlated with recurrence. Two independent radiologists reviewed all preoperative imaging to identify radiographic markers of IIH, as well as the location and size of the meningoencephalocele. From a total of 54 patients there were 5 with recurrences (9.3%), but of the 39 patients in whom a vascularized nasoseptal (n = 31) or turbinate (n = 8) flap was used there were no recurrences (p = 0.0009). The mean time to recurrence was 24.8 months (range 9-38 months). There was a trend to higher BMI in patients whose leak recurred (mean [± SD] 36.6 ± 8.6) compared with those whose leak did not recur (31.8 ± 7.4; p = 0.182). Although the lateral recess of the sphenoid sinus was the most common site of meningoencephalocele, the fovea ethmoidalis was the most common site in recurrent cases (80%; p = 0.013). However, a vascularized flap was used in significantly more patients with sphenoid (78.3%) defects than in patients with fovea ethmoidalis (28.6%) defects (Fisher's exact test, p = 0.005). Radiographic signs of IIH were equally present in all patients whose leak recurred (75%) compared with patients whose leak did not recur (63.3%); however, an enlarged Meckel cave was present in 100% (2/2) of patients whose leaks recurred compared with 13.3% (4/30) of patients whose leaks did not recur (p = 0.03). The average meningoencephalocele diameter tended to be larger (1.73 ± 1.3 cm) in patients with recurrence compared to those without recurrence (1.2 ± 0.66 cm; p = 0.22). A ventriculoperitoneal shunt was already in place in 3 patients, placed perioperatively in 5, and placed at recurrence in 2, none of whose leaks recurred. Recurrence after endonasal repair of spontaneous CSF leaks from meningoencephaloceles can be dramatically reduced with the use of a vascularized flap. Although failures of endonasal repair tend to occur in patients who have higher BMI, larger brain herniations, and no CSF diversion, the lack of vascularized flap was the single most important risk factor predictive of failure.

Analysis of computed tomography scans for development of differentiated approach to repair of ethmoid roof defects

Study of the images before surgery in order to analyze the individual characteristics of the anatomy is the key to a successful surgery. Materials and Methods: Analysis of computed tomography data of 43 patients with defects in the ethmoid roof operated from 2010 to 2020 at the Burdenko National Medical Research Center for Neurosurgery. Patients were divided into two groups according to the localization of the defect and relapses. Results. With anterior defects, the angle between the line drawn through the nasal dorsum and the perpendicular drawn through the center of the defect to the bottom of the cavity is sharper than with posterior ones, p &lt; 0.001. The height from the bottom of the nasal cavity to the ethmoid roof was greater with anterior defects than with posterior defects (p = 0.011). The height from the bottom of the nasal cavity to the cribriform plate with anterior defects is greater than with posterior ones (p = 0.006). When analyzing the ratio of the height of the middle turbinate and the distance from the septum to the orbit and when determining the length of the lattice roof anteriorly or posteriorly from the basal lamella, depending on the location of the defect with the length of the middle turbinate, it was found that the differences were statistically significant (p &lt; 0.05). Conclusions. The posterior parts of the ethmoid roof are more likely to develop iatrogenic defects due to their lower location in relation to the bottom of the nasal cavity. For the correct choice of optics and instruments, the angle between the line drawn through the nasal dorsum and the perpendicular drawn through the center of the defect to the bottom of the nasal cavity matters. A middle turbinate flap can be used to seal both anterior and posterior ethmoid roof defects. The anatomical features of the ethmoid roof do not affect the incidence of relapses.

Vascularized Pericranial Flap for Endonasal Anterior Skull Base Reconstruction.

Introduction As the limits of advanced skull base malignancies that can be managed through an endoscopic endonasal approach continue to be expanded, the resultant anterior skull base defects are of increasing size and complexity. In the absence of nasoseptal or turbinate flaps, the vascularized pericranial flap has been employed at our institution with excellent results. Objective The study aimed to review the outcomes of patients who underwent endonasal anterior craniofacial resection with anterior skull base reconstruction using a vascularized pericranial flap. Design Retrospective chart review of patients treated by the University of California - San Francisco minimally invasive skull base service from the years 2011 to 2017. Average duration of follow-up was 16.4 months. Setting This study was conducted at Academic tertiary referral center. Participants A total of nine patients with advanced anterior cranial base malignancies were identified who were treated with a minimally invasive, endoscopic anterior craniofacial resection from the years 2011 to 2017. Due to the nature of the resection in these patients, nasoseptal flaps and inferior/middle turbinate flaps were unavailable or insufficient for anterior skull base defect repair. Each patient underwent reconstruction of the anterior cranial base defect using an anteriorly based pericranial flap harvested by bicoronal incision, and tunneled anteriorly to the nasal cavity through a frontoethmoidal incision.

Outcomes of Middle Turbinate Flap in the Reconstruction of Non-tumorous Ventral Skull Base Defects - an Institutional Review.

Middle turbinate (MT) flap, based on the branches of sphenopalatine artery is one of the commonest mucosal flaps used in endoscopic skull base surgery. The objective of this study is to analyze the outcomes of the MT flap in the reconstruction of non-tumorous ventral skull base defects. A retrospective review of patients was done from 2010-19. Patients who underwent reconstruction for non-tumorous ventral skull base defects using middle turbinate (MT) flap were included in the study. The parameters assessed include patient demography, primary etiology, site of the defect, size of the defect, graft materials used, outcomes and postoperative complications. A total of 13 patients who met the study criteria were included. Three (23.07%) of the patients had meningo-encephalocele, while the remaining 10 (76.93%) had CSF fistula. Isolated foveal defect (53.8%) was the most common site involved, followed by isolated cribriform, combined cribriform-foveal and combined foveal-planar defects. Graft materials used were fascia lata, fat and septal cartilage. MT flap was successfully harvested in 11 (84.6%) patients, with successful outcome in 10/11 patients. Hypoplastic MT was present in two patients, who subsequently required Hadad flap for defect closure. No major complications were reported in the postoperative period. The MT flap is effective in the reconstruction of selective skull base defects. Appropriate surgical technique and expertise are required for successful harvest. Further studies are required to analyze its outcomes in various skull base defects.

Nasal Septal Perforation Repair with an Inferior Turbinate Flap and Acellular Dermal Matrix.

Nasal septal perforation is an uncommon disorder that can cause disturbance of nasal physiology. The perforations can vary widely in size, location, and symptomatology. Many different closure techniques have been described in the literature; however, no gold standard has been recognized. The choice of surgical technique usually depends on the characteristics of the perforation and surgeon experience. Due to the goal of perforation repair being restoration of normal nasal physiology, techniques with the best outcomes have been those resurfacing the septum with nasal respiratory mucosa. Here we present our novel surgical method for large (> 2 cm) septal perforation closure using a modification of the inferior turbinate flap repair using a polydioxanone plate and the acellular dermal matrix allograft (Alloderm, Allergan Inc.).

Vascular pedicled flaps for skull base defect reconstruction.

ObjectiveTechniques for reconstruction of skull base defects have advanced greatly since the introduction of the vascular pedicled nasoseptal flap in 2006. The objective of this review is to assess the current state of the field by examining both intranasal and extranasal techniques of vascular pedicled skull base defect repair, their indications and success rates, and novel techniques that are currently under investigation.MethodsA review of the literature describing the use of vascular pedicled flaps in skull base defect reconstruction was conducted using PubMed and Google Scholar.ResultsThe nasoseptal flap remains the most widely used vascular pedicled flap for endoscopic repair of skull base defects. Its ease of harvest, wide arch of rotation, and high success rates make it a popular choice among surgeons. Several variations including a “rescue” nasopseptal flap have been developed. Other less commonly used pedicled intranasal flaps include the middle turbinate flap and the posterior pedicled inferior turbinate flap. Additionally, several novel vascular pedicled flaps have been developed and tested in small cohorts of patients. Extranasal flaps such as the pericranial flap and the temporoparietal fascia flap are used less frequently than intranasal flaps. However, they remain valuable options for reconstruction in certain situations.ConclusionAdvancements continue to be made in the field of skull base defect reconstruction using vascular pedicled flaps. Though the nasoseptal flap remains the most widely utilized option, additional intranasal techniques continue to be developed and tested to optimize surgical outcomes and patient care.Level of EvidenceNA

Soft tissue reconstruction with anterior pedicled inferior turbinate flap in conjunction with palatal flap for standard inferior maxillectomy with hard palate resection.

The defect after surgical resection of sinonasal malignant tumors is normally reconstructed using free flaps obtained from donor sites. There is no report of using the palatal island flap to reconstruct defects after surgery. We aimed to describe our technique of soft tissue reconstruction through anterior pedicled inferior turbinate (APIT) flap in conjunction with palatal flap for standard inferior maxillectomy with hard palate resection and its outcomes and to discuss its advantages and disadvantages compared with free-flap reconstruction. For resection of malignant tumors arising from the anterior nasal septum, we preserved the hard palate during maxillectomy using a palatal island flap and an anterior pedicled inferior turbinate flap. One patient developed a small oroantral fistula, which was sealed with a denture. The other patient had a good outcome. Our technique of maxillectomy is useful for selected cases of sinonasal malignancy that require maxillary floor resection.

Intraoperative Repair of Cerebrospinal Fluid Rhinorrhea in Skull Base Tumor Resection: A Retrospective Study of Acellular Dermal Matrix Versus Turbinate Flap

The acellular dermal matrix (ADM) and turbinate flap (TF) have been widely used in the reconstruction of skull base defects. However, owing to the lack of reported data, the therapeutic effects have been controversial. The purpose of the present study was to compare the effect of the ADM and TF on cerebrospinal fluid (CSF) rhinorrhea after nasal endoscopic resection of a skull base tumor. The data from 46 patients who had undergone nasal endoscopic resection of a skull base tumor and repair of CSF rhinorrhea were retrospectively analyzed. The patients were divided into ADM and TF groups according to the difference in repair materials used. We compared and analyzed the intraoperative information and postoperative outcomes. The operation time, blood loss, defect area, and need for blood transfusion were not significantly different between the ALT and TF groups. The postoperative length of hospital stay (14.33 ± 3.66 vs. 16.76 ± 5.51 days; P= 0.669) and the incidence of complications, including wound infection (1 vs. 0; P= 0.270), intracranial infection (1 vs. 1; P= 0.900), hemorrhage (2 vs. 3; P= 0.788), 15-day CSF leak (1 vs. 2; P= 0.658), and respiratory infection (2 vs. 1; P= 0.450) were comparable between the 2 groups. The 6-month (0 vs. 0; P= 1.000) and 12-month (0 vs. 0; P= 1.000) incidence of recurrence also showed no significant differences. The use of the ADM for patients with CSF rhinorrhea showed comparable results in terms of postoperative outcomes compared with the use of TF. ADM could serve as a safe and feasible alternative for endoscopic repair of CSF rhinorrhea after nasal endoscopic resection of skull base tumors.