Nasal septal flap repair of the skull base.

The introduction of expanded endonasal approaches to the tumors of the skull base allows for meningiomas to be approached through a transnasal corridor. The resulting defects create high flow cerebrospinal fluid leaks with the need to obtain a durable closure along the anterior skull base, sphenoid planum, or clivus. The nasal septal flap has become the workhorse for endoscopic reconstruction of these defects. This chapter reviews the history, anatomy, and outcomes of the use of the nasal septal flap.