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• A Janus orthogonal nanofiber membrane was prepared for skull base repair. • The core-shell structured nanoparticles of CPP@PDA were successfully prepared. • The OPCL/PG-PCPP membrane can prevent cerebrospinal fluid leakage. • The OPCL/PG-PCPP membrane can promote cranial bone repair in rats. In neurosurgery procedures, cerebrospinal fluid leakage is a commonly encountered complication. Reconstructing skull base defects with patch materials can reduce the risk of cerebrospinal fluid leakage which can lead to serious issues such as infection, meningitis, arachnoiditis, and delayed wound healing. An ideal skull base reconstruction material should not only serve as a leak-proof barrier but also promote skull base bone regeneration. To fulfill this challenge, this research designed and fabricated a Janus orthogonal bilayer nanofiber membrane (OPCL/PG-PCPP). The aligned PCL (APCL) nanofibers were constituted as the top layer to resist cerebrospinal fluid leakage, while the perpendicular PCL/gelatin (APG) fibers with calcium polyphosphate encapsulated polydopamine nanoparticles (CPP@PDA, labeled as PCPP) were designed as the bottom layer (APG-PCPP) to facilitate osteoblast migration and osteogenic differentiation. Among these, APG-1%PCPP nanofibers demonstrated the most effective induction of osteogenic differentiation in bone marrow mesenchymal stem cells (rBMSCs). Subsequent in vivo animal experiments revealed that the bone surface area (BS), bone volume fraction (BV/TV), and number of trabeculae (Tb.N) in the APG-1%PCPP group were twice as high as those in the control group, which confirmed the good osteogenic potentials. Therefore, due to its unique leak-proof and osteoinductive properties, the OPCL/PG-PCPP membrane holds promise as an applicable skull base reconstruction material in the field of neurosurgery. [Display omitted] [ABSTRACT FROM AUTHOR]

The pedicled temporoparietal fascial flap has played a role in reconstructive strategies for defects of the head and neck for well over a century. Although partially succeeded by more recent microvascular free tissue transfer techniques, this well-vascularized and pliable flap has remained an important tool in the reconstruction of locoregional defects of the temporal bone, orbitomaxillary complex, and anterior skull base. Furthermore, with little donor site morbidity and relative ease of harvest this flap is likely to remain a key tool in the reconstructive armamentarium of head and neck and skull base surgeons. In this article we review the anatomy, operative technique, potential complications, and applications of the pedicled temporoparietal fascial flap. [ABSTRACT FROM AUTHOR]

The introduction of the vascularized pedicled nasoseptal flap has revolutionized endoscopic skull base surgery, providing a highly versatile option to repair even the most complex skull base defects. Though demonstrated with outstanding results in adult patients, there is limited experience in the pediatric population. Early investigation found that there are limitations in utilization of the nasoseptal flap in children due to craniofacial restrictions. More recently, these concerns have been mitigated, and nasoseptal flaps are reliably used in reconstructing even the largest skull base defects in the youngest patients. Preoperative planning and review of imaging and meticulous intraoperative dissection are essential for successful reconstructive outcomes. [ABSTRACT FROM AUTHOR]

Pediatric skull base and craniofacial surgery presents a unique challenge since the potential benefits of therapy must be balanced against the cumulative impact of multimodality treatment on craniofacial growth, donor-site morbidity, and the potential for serious psychosocial issues. Skull base reconstruction using locoregional flaps or free flaps may be safely performed in pediatrics. Although the general principles of skull base reconstruction are applicable to nearly all patients, the unique demands of skull base surgery in pediatrics merit special attention. Multidisciplinary care in experienced centers is of utmost importance. [ABSTRACT FROM AUTHOR]

Improvements in skull base surgery techniques have allowed surgeons to expand the indications for resection and reconstruction of aggressive tumors. The increasingly complex defects following surgical extirpation are often reconstructed with microvascular free flaps. Techniques for free flap reconstruction of the anterior skull base are elaborated. [Copyright &y& Elsevier]

Advances in endoscopic techniques and technology have substantially increased the scope of endonasal skull base surgery. Large dural defects after expanded endonasal approaches (EEA) present a challenge for reconstruction and have revealed the limitations of conventional reconstructive methods. Initial reconstructive attempts using nonvascularized free tissue grafts resulted in unacceptably high rates of cerebrospinal fluid fistulae. The advent of vascularized, pedicled flaps has substantially improved these outcomes. These flaps also have the advantage of a large surface area and can be mobilized over a large arc of rotation. Vascularized tissue heals quickly and can tolerate postoperative radiation therapy. We have developed 3 nasal vascularized flaps that can be used for skull base reconstruction after EEA. The anatomy, technique, and reconstructive considerations for the nasoseptal flap, the inferior turbinate flap, and the middle turbinate flap will be reviewed in detail in the following report. [Copyright &y& Elsevier]