Reverse rotation flap for reconstruction of donor site after vascular pedicled nasoseptal flap in skull base surgery

Endonasal skull base surgery is growing exponentially as a subspecialty. In recent years, advances in endoscopic techniques and intraoperative navigation systems have allowed us to expand the indications of endoscopic skull base surgery. Major skull base centers worldwide are addressing larger and more complex lesions using endoscopic techniques. As a consequence, the skull base defects are more challenging to reconstruct. In this report, we present a novel technique to reconstruct the denuded septum remaining after the use of the vascular pedicled nasoseptal flap.