title: Tips and Tricks for Anterior Cranial Base Reconstruction.
abstract: Reconstruction procedures come last in skull base surgery, but they are not the least important phase-rather, reconstruction is one of the most important steps required to prevent complications. In our opinion, there are three general principles upon which a good reconstruction of the skull base stand: (1) anatomo-surgical knowledge; (2) approach/route selection; and (3) the cooperation of the skull base surgical team. In general, three major complications may occur when a good skull base reconstruction has not been achieved, i.e., cerebrospinal fluid (CSF) leak, pneumoencephalus, and infection. Reconstruction of skull base defects requires a thorough knowledge of surgical anatomy, disease, and patient risk factors. Various reconstruction techniques are available, from free tissue grafting to vascularized flaps. Possible complications that can occur after these procedures need to be considered.The reconstruction phase of the surgical procedure is a fundamental step in any surgical approach and it must not be ignored.
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy. oreste.dedivitiis@unina.it.
authors.forename: Oreste
authors.initials: O
authors.lastname: de Divitiis
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Di Somma
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Cavallo
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cappabianca
mesh_terms: D065634:Cerebrospinal Fluid Leak / Q000453:epidemiology; D006801:Humans; D044583:Neuroendoscopy / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D011007:Pneumocephalus / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D019291:Skull Base / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology
keywords: CSF leak; Endoscopic endonasal surgery; Reconstruction; Skull base surgery; Transcranial surgery