Experience of skull base defect reconstruction using local pedicled grafts in endoscopic transsphenoidal surgery

: Since endoscopic technique was introduced in transsphenoidal surgery, the midline skull base from olfactory fossa to craniocervical junction has become available through transnasal corridor. One of the most challenging aspects in these types of surgery is watertight closure of skull base defect and prevention of postoperative CSF leaks. Various materials and sealants are applied in different clinics. Recently mucoperiosteal flap from nasal septum was introduced as "gold standard" for multilayer skull base reconstruction. We present our algorithm for selection of skull base reconstruction technique in endoscopic endonasal surgery. We demonstrate our experience of using of pedicled autografts (middle turbinate and mucoperiosteal flap). Surgical technique of grafting is described in details. Clinical results in 41 surgically treated patients are presented. First results of using of pedicled autografts demonstrated high effectiveness of this technique with acceptable rates of nasal complications in comparison to standard methods.