Skull base reconstruction following resection of skull base chordomas and chondrosarcomas

Resection of skull base chordomas and chondrosarcomas can create large dural defects that involve multiple cisterns or the third ventricle leading to high-flow cerebrospinal fluid leaks. Reconstruction of the skull base is essential to an uncomplicated postoperative course. In general, small dural defects can be repaired successfully with multilayer graft in at least 90% of cases. However, repair of larger defects with high-flow cerebrospinal fluid leakage, or of defects in the petroclival area, is more challenging and often requires a local or regional pedicled vascularized graft. When these are unavailable, free microvascular tissue transfer is an option. In this chapter, we discuss all available options to reconstruct skull base defects following endoscopic endonasal or open resection of petroclival chordomas and chondrosarcomas.

Duke Scholars

Author Ralph Abi Hachem Rhinology and Skull Base Surgery