Marco Ferrari

Background Modern achievements in transnasal endoscopic skull base (SB) surgery have led to complex resections that render reconstruction a challenge. Temporoparietal fascia flap (TPFF) is a suitable option for SB reconstruction. The side‐door TPFF technique for anterior SB reconstruction is described here for the first time in a real‐life surgical setting. Methods Patients affected by a SB malignancy who underwent cranioendoscopic resection were included. For reconstruction, a multilayer reconstruction technique including side‐door TPFF transposition was employed. Results TPFF transposition was performed in five patients. The TPFF could be easily transposed via a side‐door approach. It adequately covered the edges of the defect and supported optimal healing of the surgical site. During follow‐up, vitality and integration of the TPFF were assessed endoscopically and radiologically. Conclusions The TPFF side‐door transposition technique is a valuable option in anterior SB reconstruction that can provide fast and effective healing, especially in patients needing adjuvant radiotherapy.