Abstract
Reconstruction procedures come last in skull base surgery, but they are not the least important phase—rather, reconstruction is one of the most important steps required to prevent complications. In our opinion, there are three general principles upon which a good reconstruction of the skull base stand: (1) anatomo-surgical knowledge; (2) approach/route selection; and (3) the cooperation of the skull base surgical team. In general, three major complications may occur when a good skull base reconstruction has not been achieved, i.e., cerebrospinal fluid (CSF) leak, pneumoencephalus, and infection. Reconstruction of skull base defects requires a thorough knowledge of surgical anatomy, disease, and patient risk factors. Various reconstruction techniques are available, from free tissue grafting to vascularized flaps. Possible complications that can occur after these procedures need to be considered.
The reconstruction phase of the surgical procedure is a fundamental step in any surgical approach and it must not be ignored.
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References
Cavallo LM, Messina A, Esposito F et al (2007) Skull base reconstruction in the extended endoscopic transsphenoidal approach for suprasellar lesions. J Neurosurg 107:713–720
De Divitiis E, Esposito F, Cappabianca P et al (2008) Tuberculum sellae meningiomas: high route or low route? A series of 51 consecutive cases. Neurosurgery 62:556–563; discussion 556–563
De Divitiis O, Angileri FF, D’avella D et al (2002) Microsurgical anatomic features of the lamina terminalis. Neurosurgery 50:563–569; discussion 569–570
De Divitiis O, Conti A, Angileri FF et al (2004) Endoscopic transoral-transclival approach to the brainstem and surrounding cisternal space: anatomic study. Neurosurgery 54:125–130; discussion 130
De Divitiis O, Iacopino DG, Solari D et al (2010) Subfrontal approaches. In: Cappabianca P, Califano L, Iaconetta G (eds) Cranial, craniofacial and skull base surgery. Springer, Milan, pp 17–25
De Notaris M, Topczewski T, De Angelis M et al (2013) Anatomic skull base education using advanced neuroimaging techniques. World Neurosurg 79(S16):e19–13
Gil Z, Abergel A, Leider-Trejo L et al (2007) A comprehensive algorithm for anterior skull base reconstruction after oncological resections. Skull Base Off J N Am Skull Base Soc [et al.]. 17:25–37
Reyes C, Mason E, Solares CA (2014) Panorama of reconstruction of skull base defects: from traditional open to endonasal endoscopic approaches, from free grafts to microvascular flaps. Int Arch Otorhinolaryngol 18:S179–S186
Snyderman CH, Kassam AB, Carrau R et al (2007) Endoscopic reconstruction of cranial base defects following endonasal skull base surgery. Skull Base Off J N Am Skull Base Soc [et al.] 17:73–78
Tabaee A, Anand VK, Brown SM et al (2007) Algorithm for reconstruction after endoscopic pituitary and skull base surgery. Laryngoscope 117:1133–1137
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de Divitiis, O., Di Somma, A., Cavallo, L.M., Cappabianca, P. (2017). Tips and Tricks for Anterior Cranial Base Reconstruction. In: Visocchi, M., Mehdorn, H.M., Katayama, Y., von Wild, K.R.H. (eds) Trends in Reconstructive Neurosurgery. Acta Neurochirurgica Supplement, vol 124. Springer, Cham. https://doi.org/10.1007/978-3-319-39546-3_26
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DOI: https://doi.org/10.1007/978-3-319-39546-3_26
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