Open and Endoscopic Open-Assisted Repair of Anterior Skull Base Defects.

Although endoscopic surgery has become more prevalent and favorable than open approaches, open and combined approaches remain relevant. Such situations include extensive tumors involving potential flap donor sites, visualization and instrumentation limitations of the frontal sinus, and prior surgery/radiation requiring greater access and alternative flap reconstruction. Combined approaches use the foundation of open craniotomy and endoscopic techniques to preserve the frontal outflow tract and frontal sinus mechanism while repairing cerebrospinal leaks caused by anterior skull base defects.