Skull base reconstruction after anterior craniofacial resection

Anterior craniofacial resection has become a popular operation for nasoethm oid tumours involving the skull base. Many papers have been published since the first by Ketcham ct al, in 1963, However, there is still controversy a bout the method for reconstruction of an anterior skull base defect after r esection, The simple reconstruction of Ketcham has been followed by more so phisticated procedures using galeal-pericranial flaps, free flaps with micr ovascular anastomosis and bony or alloplastic augmentation. The main purpos es of the reconstructions are to prevent brain herniation, to avoid intracr anial infections, to diminish the risk of CSF leakage and to avoid pneumoce phalus. From the relevant Literature and our own experience of 168 anterior craniofacial resections, we conclude that a pedicled pericranial flap is t he best choice for closing a cranial base defect, (C) 1999 European Associa tion for Cranio-Maxillofacial Surgery.