Pericranial flap for closure of paramedian anterior skull base defects.
OBJECTIVE
We sought to examine the position of a pericranial flap reconstruction of anterior skull base defects with respect to the original floor of the anterior cranial fossa.


METHODS
A retrospective chart and radiology review of 17 patients (1993-2001) with pericranial flap reconstruction for anterior skull base defects and 17 controls was performed.


RESULTS
At 6 or more months after surgery, the new positions of the pericranial flaps ranged from 5 mm above to 11.3 mm below the positions of the original cribriform plates. There were no complications related to the pericranial flaps such as hemorrhage, flap loss, or brain herniation except for 2 (11.8%) cerebrospinal fluid leaks, 1 of which required operative correction.


CONCLUSIONS
Pericranial flap reconstruction is a reliable method with low morbidity for closure of the most common skull base defect from the craniofacial resection that entails removal-unilateral or bilateral-of the fovea ethmoidalis, cribriform plate, and/or superior septum. This flap creates a watertight seal between the extradural space and the nasal cavity, prevents clinically significant brain herniation, and is associated with a low rate of cerebrospinal fluid leakage even without postoperative lumbar subarachnoid drainage of the cerebrospinal fluid.
Noone
Michael C
MC
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, 11th Floor, Charleston, SC, USA.
Osguthorpe
J David
JD
Patel
Sunil
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D035262:Cranial Fossa, Anterior / Q000000981:diagnostic imaging / Q000601:surgery; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012016:Reference Values; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology