Pedicled lateral nasal wall flap for endoscopic skull base reconstruction: how I do it.

BACKGROUND

The pedicled nasoseptal flap (Hadad-Bassagasteguy flap, HBF) has been considered as the workhorse for reconstruction of high-flow cerebrospinal fluid (CSF) leak following endoscopic endonasal skull base surgery. However, if the septal mucosa is affected by a tumor or the vascular pedicle is injured due to prior surgery, the use of HBF is precluded.

METHOD: We illustrate the harvest techniques of the lateral nasal wall flap (LNWF) based on the posterior lateral nasal artery (PLNA).

CONCLUSION

The LNWF is a robust intranasal regional flap with a consistent blood supply and comparable coverage surface, making it a reliable alternative when the HBF is unavailable.