Free graft techniques in skull base reconstruction.

Over the last 20-30 years, the management of anterior skull base defects, CSF leaks and encephaloceles has shifted towards endoscopic, minimally invasive approaches. Whether their etiology is spontaneous or traumatic, the large majority of these lesions can be repaired with free mucosal grafts. Such grafts may be readily harvested from the nasal septum or turbinates and applied as either a single layer reconstruction for small leaks or as a multilayer reconstruction for larger defects. The accessibility, ease of placement, and high take rate associated with free mucosal grafts makes them a wise and popular choice for reconstruction of many skull base defects.