title: Anterior pedicle lateral nasal wall flap: a novel technique for the reconstruction of anterior skull base defects.
abstract: OBJECTIVE
  Expansion of the clinical indications for ablative endoscopic endonasal approaches has behooved us to search for new reconstruction alternatives. We present the anatomic foundations of a novel anterior pedicled lateral wall flap (Hadad-Bassagaisteguy 2 or HB2 flap) for the vascularized reconstruction of anterior skull base defects.
  
  
  METHODS
  Anatomic description. Feasibility study. Technical report
  
  
  METHODS
  Using a cadaveric model, we investigated the feasibility of harvesting an anteriorly based mucoperiosteal flap from the lateral nasal wall. We then applied the techniques developed in the anatomical laboratory to reconstruct two patients with defects resulting from the endoscopic endonasal resection of esthesioneuroblastomas and one patient with an extensive meningoencephalocoele of the anterior cranial fossa.
  
  
  RESULTS
  HB2 flaps were harvested and transposed to reconstruct anterior skull base defects in cadaveric specimens, and subsequently, in three patients. The HB2 flap provided adequate coverage in the cadaveric model, as well as clinically in our three patients. Their postoperative healing was uneventful.
  
  
  CONCLUSIONS
  The HB2 flap is a feasible alternative for the reconstruction of anterior skull base defects in select patients.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Medical School of Ciudad de Rosario, Provincia de Santa Fe, Republica Argentina.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Hadad
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Rivera-Serrano
authors.forename: Luis H
authors.initials: LH
authors.lastname: Bassagaisteguy
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Carrau
authors.forename: Juan
authors.initials: J
authors.lastname: Fernandez-Miranda
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Prevedello
authors.forename: Amin B
authors.initials: AB
authors.lastname: Kassam
mesh_terms: D006801:Humans; D009296:Nasal Cavity; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D019291:Skull Base / Q000000981:diagnostic imaging / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply