Infant Nasoseptal Flap Skull Base Reconstruction in a Resource-Limited Setting in Ghana.

Abstract

The pedicled nasoseptal flap (NSF) for skull base reconstruction has transformed the management of anterior skull base pathology. Despite its widespread adoption in adults and older pediatric patients, its application in infancy and younger children remains limited. Furthermore, its use in this population in low-resource settings is rarely reported. We present a surgical technique using simple instrumentation for the successful NSF reconstruction of a congenital anterior cranial fossa meningoencephalocele and cerebrospinal fluid (CSF) leak in an infant in Accra, Ghana, which has not been previously reported in Africa. The postoperative course was uneventful, and follow-up demonstrated no CSF leak or surgical complications. Her care was delivered at Korle-Bu Teaching Hospital in Accra, Ghana. We present a surgical technique for NSF skull base reconstruction using basic instrumentation that can be safely and effectively performed in an appropriately selected young infant in a resource-limited setting. This technique represents the first such case to our knowledge in Africa.