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June 1988

Reconstruction of the Anterior Skull Base Following Cranial Facial Resection

Author Affiliations

Salt Lake City

Arch Otolaryngol Head Neck Surg. 1988;114(6):680. doi:10.1001/archotol.1988.01860180094043

To the Editor.—Regarding a recent article published in the Archives,1 the pericranial flap is indeed an excellent flap for reconstruction of midline anterior skull base defects. In addition to the use of this flap, which has an obvious advantage in reconstruction because of its good vascular supply, we have used bone obtained from the inner table of the frontal craniotomy bone flap. This can be easily taken using a bone saw (Midas Rex) with little risk of fracturing the remaining bone flap. It can be cut to the exact size needed to fit the defect and results in no cosmetic problem for the patient. After placing the bone graft in position, we have then secured it by using a screw (placed anteriorly) through the anterior edge of the graft into the remaining bone. A small miniplate might also be used for the same purpose, allowing good fixation of

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