LAUSR

BACKGROUND With the advent of modern endoscopes and better anatomic understanding of the skull base, the indications of endonasal approaches are increasing. These procedures may be complicated by high rates of postoperative cerebrospinal fluid (CSF) leak and reconstruction of the defect remains challenging. In the anterior skull base, vascularised grafts have been reported as superior in preventing CSF leakage and infection. The Hadad-Bassagasteguy flap (HBF),being a pedicled flap is our first line flap to reconstruct the skull base. When we were not successful with this flap, we resorted to different flaps. OBJECTIVE We modified the originally described temporoparietal fascial flap (TPFF) by Fortes et al. and applied clinically. The objective of this paper is to briefly describe the modification of the flap and to review the clinical outcome. METHODS From 2014 to 2018, in 6 cases of CSF leak with the appropriate indication we used the temporoparietal myofascial flap (TPTMFF) repair which is a modification of the temporoparietal fascial flap (TPFF) by Fortes et al. We took all the 6 patients in our study and followed them up. RESULTS All of the 6 repairs were successful and no CSF leak was found just after the operation in 6 to 48 months followup. CONCLUSION We recommend our modified novel TPTMF flap as a very good option in case of failed cases of postoperative CSF leak.