Multilayer reconstruction of the anterior cranial fossa floor

A case is described where a reconstruction of a complex defect in the floor of anterior cranial fossa was successfully carried out using multiple layers of vascularised pedicle flaps. The 42-year-old male patient had previously undergone multiple surgical procedures for persistent cerebrospinal fluid (CSF) rhinorrhoea following a vehicular accident 16 years previously. The extensive vascular supply to the layers of the scalp, pericranium, temporalis muscle and its fascial coverings was exploited in fashioning the flaps.