Locoregional flaps in pediatric anterior skull base surgery

Management of skull base defects involves the separation of the cranial cavity from the nasal cavity in order to prevent cerebrospinal fluid leak, pneumocephalus, and intracranial infection. The size and location of the defect as well as donor tissue available will determine the type of reconstruction. Reconstruction options include free tissue grafts, locoregional flaps, and microvascular free flaps. In children, the size of potential flaps must be considered as well as the length of the pedicle, as often these differ in children. This article will discuss numerous reconstructive options, focusing on locoregional flaps in skull base reconstruction. In addition to outlining the surgical technique for each type, we will review considerations in pediatric patients for each reconstructive option.