Synthetic Materials for Skull Base Reconstruction

Significant advances in endoscopic sinus and skull base surgery can be attributed to the development of angled telescopes, navigation systems, and high definition cameras coupled with a better understanding of the endoscopic anatomy of the nasal cavity and ventral skull base [1, 2]. As a consequence of these advancements, skull base defects are now able to be managed through transnasal approaches using autografts [3]. The first endoscopic cerebrospinal fluid (CSF) leak repair was described by Wigand in 1981 [4] with the same principles for CSF leak repair applied subsequently for the repair of the defects resulting from endoscopic resection of skull base and intracranial tumors [5]. The use of vascularized flaps laid the ground for further advancements in endoscopic skull base approaches as the repair of complex and large defects that resulted from tumor resections were repaired with a success rate similar to the open approaches [5, 6].