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Review
. 2024 Jan 5;16(2):242.
doi: 10.3390/cancers16020242.

Skull Base Reconstruction by Subsite after Sinonasal Malignancy Resection

Kristen Kraimer  1 , Mathew Geltzeiler  1
Affiliations
Review

Skull Base Reconstruction by Subsite after Sinonasal Malignancy Resection

Kristen Kraimer et al. Cancers (Basel). .

Abstract

Reconstruction after the resection of sinonasal malignancies is complex and primarily dependent on the defect size and location. While the reconstructive paradigm for sellar mass resection is well delineated, the challenges associated with reconstruction after sinonasal malignancy resection are less well described. This narrative review will address the goals of reconstruction after both endonasal endoscopic and open sinonasal malignancy resection and reconstructive options specific to these subsites. The goals of reconstruction include repairing cerebrospinal fluid leaks, restoring sinonasal function, providing a nasal airway, and optimizing the patient's quality of life. These goals are often complicated by the anatomic nuances of each involved sinus. In this review, we will discuss the methods of reconstruction specific to each sinonasal subsite and describe the factors that guide choosing the optimal reconstructive technique.

Keywords: cerebrospinal fluid leak repair; nasoseptal flap; sinonasal malignancy; sinonasal squamous cell carcinoma; skull base reconstruction.

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Conflict of interest statement

M.G. is a consultant for Medtronic and Stryker but neither relationship is relevant to this review article. K.K. has no conflict of interest to disclose.

Figures

Figure 1
Figure 1
(A) Preoperative T1 post-contrast coronal image demonstrating a large right sinonasal mass. (B) Intraoperative endoscopic view of the anterior skull base after esthesioneuroblastoma resection. The skull base was reconstructed with a synthetic dura, fascia lata, and a left-sided pedicled nasoseptal flap. (C) Postoperative coronal MRI image demonstrating skull base reconstruction along the resection bed.
Figure 2
Figure 2
Postoperative T1 post-contrast sagittal MRI images of a well-healed nasoseptal flap (arrow).
Figure 3
Figure 3
A patient with recurrent adenoid cystic carcinoma. (A) Preoperative coronal MRI image demonstrating extensive orbital and skull base involvement. (B) Postoperative post-contrast T1-weighted sagittal MRI images after eft orbital exenteration, suprastructure maxillectomy, frontal craniectomy, and ALT reconstruction (C) Postoperative post-contrast T1-weighted coronal MRI images.
See this image and copyright information in PMC

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