Clival defect
Reconstruction of large clival defects after an endoscopic endonasal approach is challenging.
A Extended nasoseptal flap, which adds the nasal floor and inferior meatus mucosa adds a significant area for reconstruction of the clivus. A defect laterally beyond the hypoglossal canals is not likely covered with this variation of the flap. Preoperative CT scans are useful to guide the reconstruction techniques 1).
1)
Peris-Celda M, Pinheiro-Neto CD, Funaki T, Fernandez-Miranda JC, Gardner P,
Snyderman C, Rhoton AL. The extended nasoseptal flap for skull base
reconstruction of the clival region: an anatomical and radiological study. J
Neurol Surg B Skull Base. 2013 Dec;74(6):369-85. doi: 10.1055/s-0033-1347368.
Epub 2013 Jun 17. PubMed PMID: 24436940; PubMed Central PMCID: PMC3836807.