Improving the Design of the Pedicled Nasoseptal Flap for Skull Base Reconstruction: A Radioanatomic Study

Abstract

The length of the nasal septum comprises sufficient mucoperichondrium and mucoperiosteum to allow the harvesting of a nasoseptal flap that could cover any defect resulting from an anterior skull base, a transsellar/transplanar, or a transclival EEA. Similarly, the height of the nasal septum has the potential to yield a nasoseptal flap with a width that is adequate to cover the laterolateral aspect of any defect of the anterior skull base and clivus. Skull base defects resulting from combined EEAs, such as those that would create a defect that comprises the skull base from sella turcica to frontal sinus, are beyond the potential dimensions of a single nasoseptal flap. This and other defects resulting from a combination of EEAs require other strategies, such as the use of bilateral nasoseptal flaps, or the use of other reconstructive options.