Endoscopic reconstruction of skull base defects using a nasal septal flap in paediatric patients

Abstract Introduction: The repair of skull base defects after skull base surgeries is a major problem. Postoperative cerebrospinal fluid leak in reconstruction of the anterior skull base defect using a nasal septal flap was minimal when compared with other techniques. The nasal septal flap should be considered as the first line of treatment after transnasal endoscopic skull base surgery. Objectives: Evaluation of the usefulness and reliability of endoscopic endonasal skull base reconstruction using a nasal septal flap. Patients and methods: This study was carried out on 10 paediatric patients with skull base defects because of different pathologies. These patients were admitted in El-Kasr El-Ainy Hospital, Otorhinolaryngology Department. These patients included one patient with a germ cell tumour, five patients with a congenital encephalocele and four patients with skull base defects because of trauma to the skull base. Results and conclusion: Various endoscopic techniques have been described to separate the cranial cavity from the sinonasal cavity to prevent infection, pneumocephalus and cerebrospinal fluid leak. Different techniques were used to close the anterior skull base defects such as multilayer free graft, suturing the dural defect combined with free graft and reconstruction based on a vascularized graft. The nasal septal flap should be considered as the first line of treatment after transnasal endoscopic skull base resections. © 2013, The Egyptian Oto - Rhino - Laryngological Society.