351 Anterior Ethmoid Artery Septal Flap for Endoscopic Reconstruction of Frontal Sinus CSF Leak

Abstract Introduction Anterior skull base cerebrospinal fluid (CSF) leaks are managed successfully with endonasal surgery. Endoscopic closure of CSF from posterior table the frontal sinus remains challenging. Vascularized Hadad-Bassagasteguy flap (HBF) reconstruction has increased rates but does not extend to sinus. We describe our technique using septal pedicled by anterior ethmoid artery (AEA) for repairing defects. Method Retrospective review cases leak repair AEA reconstruction. Flap design: an vertical mucosa incision at border sinusotomy is made and extended nasal floor. Posterior 1 cm projection axilla middle turbinate on septum A horizontal along floor joins two incisions. The raised rotated into over reconstructed defect. Results Three patients identified. Two males, one female, aged 11, 33 56. Patient histories included recurrent bacterial meningitis following head trauma, sinusitis fronto-ethmoidal osteoma, intraoperative rhinorrhea due meningoencephalocele. three wall defects were repaired endoscopically multilayer flap. Conclusions can be utilised repair. conveniently located When intact it provides excellent final layer as part