The Posterior Pedicle Inferior Turbinate Flap: A New Vascularized Flap for Skull Base Reconstruction

Abstract

Introduction: Expanded endonasal approaches (EEA) for the resection of lesions of the anterior and ventral skull base can create large defects associated with a significant risk of postoperative cerebrospinal leaks and/or exposure of the internal carotid artery. In these cases, a reconstruction using a vascularized flap is advantageous to facilitate rapid and complete healing of the defect. The Hadad-Bassagasteguy (HBF), a posterior nasoseptal pedicle flap, is our preferred reconstructive option; however, prior posterior septectomy or prior wide sphenoidotomies preclude its use. We have developed two additional pedicled flaps to reconstruct these selected cases: the transpterygoid temporoparietal fascial flap (TPFF), more suitable for large defects, and the posterior pedicle inferior turbinate flap (PPITF), the subject of this paper.