One-piece bifrontal basal craniotomy with pericranial flap for frontal sinus management: How I Do It.

BACKGROUND

Anterior skull base surgery poses challenges including cerebrospinal fluid (CSF) leakage and cosmetic concerns. A novel one-piece bifrontal basal craniotomy using a pericranial flap was developed to improve outcomes.

METHOD: The technique included precise burr hole placement, dura-protective craniotomy, and frontal sinus sealing using a pericranial flap. Reconstruction was stabilized using miniplates and screws, leaving the epidural dead space unfilled and lowering infection risks.

CONCLUSION

This method reduces CSF leakage, enhances reconstruction durability, and preserves cosmetic and functional outcomes, offering a reliable approach for anterior skull base surgery.