Use of the Vascularized Lateral Nasal Wall Flap for Closure of Complex Skull Base Defects.

This article discusses the use of the vascularized lateral nasal wall flap (LNWF) in endoscopic endonasal surgery (EES) for closure of complex skull base defects. The study presents a 15-year single-institutional experience with the LNWF, focusing on its role in providing durable closure after intradural endoscopic endonasal tumor resection. The LNWF is an axial transposition flap based on the inferior turbinate artery and its branches, and it can be modified to include the nasal floor and nasal septum for reconstruction of large skull base defects. The primary outcomes measured were postoperative flap necrosis and cerebrospinal fluid (CSF) leak. The study found that the LNWF successfully addressed CSF leak in 64% of cases and that postoperative CSF leak occurred in 28.5% of cases with intraoperative leak. The most common adverse outcomes associated with LNWF closures were CSF leak and flap necrosis. Overall, the LNWF is a valuable technique for the treatment of persistent CSF leaks after endonasal surgery. [Extracted from the article]