Table 1.

Intranasal and regional vascular flaps available for skull base reconstruction

Location	Vascular Tissue Flap	Pedicle	Advantages/Uses	Disadvantages/Limitations
Intranasal	NSF	Posterior septal artery (from SPA)	Ideal for all skull base reconstructions	Size limitation in pediatric patients
	ITF	Inferior turbinate arteryΦ	Good for small clival defects	Cannot reach ACF or sella Crusting over denuded turbinate
	MTF	Middle turbinate arteryΦ	Good for small ACF or transphenoidal defects	Small in size Thin mucosa Difficult to elevate
Regional	PCF	Supraorbital & supratrochlear arteries	Hearty flap with versatile dimensions Extends from ACF to sella	Does not extend to posterior skull base Requires external incision
	TPFF	Superficial temporal artery	Good for clival or parasellar defects Usually from non-irradiated field	90° pedicle rotation limits reconstruction of ACF Requires external incision
	PF	Greater palatine artery	Theoretically can reach all areas of skull base Long (3 cm) pedicle	Difficult to dissect pedicle Donor site morbidity Unproven clinically
	FAB	Facial artery	Useful for anterior skull base No facial incision	Potential paresthesia or persistent epiphora Potential introduction of oral flora to sterile field Unproven clinically
	OGP	Occipital artery	Good for posterior lesions Potential for very large area of coverage Long (8+ cm) pedicle Usually from non-irradiated field	Potential for carotid injury with proximal dissection of pedicle Unproven clinically

^Φterminal branch of posterior lateral nasal artery of the sphenopalatine artery

SPA – Sphenopalatine artery, NSF – Nasoseptal Flap, ITF – Inferior Turbinate Flap, MTF – Middle Turbinate Flap, PCF – Pericranial Flap, TPFF – Temporoparietal Fascia Flap, PF- Palatal Flap, FAB – Facial Buccinator Flap, OGP – Occipital Galeopericranial Flap, ACF – Anterior Cranial Fossa