This study described our technique of harvesting and transferring a free nasal floor mucoperiosteal graft and discussed our experience with applying this technique.

The present study was a retrospective review of 19 patients treated with image-guided endoscopic sinus surgery for chronic rhinosinusitis or tumors. Intraoperative free mucosal graft repair was performed for large skull base defects after resection of skull base tumor, CSF leak, and iatrogenic CSF leak. The repair was performed in an overlay or an underlay fashion, with a multilayer approach in a large skull base defect. Patients underwent endoscopic assessment at six days, five weeks, and 12 weeks after surgery to assess healing and CSF leak. The patients were followed up for a mean of 8.7 months.

All the patients had complete healing at the donor site and the recipient site, with minimal morbidity at 5 and 12 weeks, and no evidence of recurrent CSF leak.

The use of nasal floor mucoperiosteal free grafts in endoscopic surgery offered the advantage of the ease of harvest, coverage of large defects, and multiple service applications, with minimal donor-site morbidity.