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Skull Base Reconstruction and CSF Leak Repair

Last Updated: September 30, 2018

Any endoscopic endonasal skull base procedure may be divided into the same three phases described for traditional “open” skull base operations: 1) approach (exposure), 2) definitive procedure (resection), and 3) reconstruction (closure). Our rhinology colleagues primarily undertake the first and last phases of the operation and drive the endoscope during the resection phase. Importantly, this team approach and mutual learning advances the care of our patients.

Each of these phases requires a different set of goals and objectives as well as techniques. In this chapter, I will discuss the basic tenets of surgical technique for skull base reconstruction and cerebrospinal fluid (CSF) leak repair.

Once hemostasis is obtained, a decision point has been reached. In an extradural procedure where...