Reconstruction of the median anterior skull base with an intracranial free radial forearm flap after recurrent resection of tumour

Abstract

We report a case of a median anterior skull base defect that was reconstructed with a free radial forearm flap. The flap was used intracranially, whereas the vascular anastomosis was made extracranially, with the pedicle running through a burr hole in the skull. This technique was succesful in sealing the skull base from the nasal cavity and preventing leakage of cerebrospinal fluid, infection, or herniation of brain tissue. We report the reconstructive procedure, an overview of other options, and the reasons for the decisions in this case.

Key Words::

• Reconstruction of skull base
• skull base defects
• radial forearm flap
• anterior skull base reconstruction
• flap selection
• dural repair
• microsurgical anastomosis
• limiting complications
• long vascular pedicle