Pedicled lateral nasal wall flap for endoscopic skull base reconstruction: how I do it

Abstract Background The pedicled nasoseptal flap (Hadad-Bassagasteguy flap, HBF) has been considered as the workhorse for reconstruction of high-flow cerebrospinal fluid (CSF) leak following endoscopic endonasal skull base surgery. However, if the septal mucosa is affected by a tumor or the vascular pedicle is injured due to prior surgery, the use of HBF is precluded. Method We illustrate the harvest techniques of the lateral nasal wall flap (LNWF) based on the posterior lateral nasal artery (PLNA). Conclusion The LNWF is a robust intranasal regional flap with a consistent blood supply and comparable coverage surface, making it a reliable alternative when the HBF is unavailable.