Skull-base reconstruction following oncological procedures

Tumor resection may create extensive skull-base defects requiring meticulous reconstruction. There is no single gold standard technique for anterior cranial base reconstruction. The fascia lata offers a versatile and reliable method of dural reconstruction. Neovascularization of the fascia lata graft provides long-term viability without an overlying vascularized flap. Reconstruction of the medial orbital wall is performed only after extensive resections. For extensive orbital resections and exenterations use a temporalis muscle rotational flap. For a radical maxillectomy use a musculocutaneous free flap supported by an obturator. Use pericranial wrapping if adjuvant radiation therapy is planned in order to prevent osteoradionecrosis.