ABSTRACT
The advent of endoscopic sinus surgery and reconstruction techniques in the form of grafts and flaps has caused a drastic reduction of post-operative failures, from as high as 30–40% in the past to current rates of about 6.7–11.5%. Grafts like autologous tissues, collagen, and human acellular dermis have been used. The posteriorly based intranasal pedicled flap i.e., the nasoseptal flap, is still considered the workhorse for skull base reconstruction. The pericranial flap is the most common second-line vascular flap used, based on the supraorbital and supratrochlear arteries. The advent of microvascular free flaps has revolutionized reconstruction techniques, with their ability to reach distant sites in the skull base. The augmentation of these techniques with synthetic materials like titanium mesh and polymethylmethacrylate (PMMA), and supplements like fibrin glue has significantly reduced complications and improved quality of life.
