The reconstruction of anterior skull base defects after carcinologic surgery is challenging. Large defects can require the use of autologous free tissue transfer. Currently, most reconstructions use soft-tissue flaps. We describe the use of an osteocutaneous radial forearm free flap to reconstruct a large defect secondary to a malignant paraganglioma extending into the anterior cranial fossa and both orbits. The surgical resection required endonasal and transcranial approaches. We reconstructed the defect with a free osteocutaneous radial forearm flap. We laid the bone flap across the defect, resting on the orbital roof on each side, and sutured the soft component to the edge of the dura. The pedicle was funnelled from the craniotomy to a prepared cervicotomy and the micro-anastomoses were performed onto the facial artery and two satellite veins. Potential indications and major drawbacks of this technique are briefly discussed. Osteocutaneous radial forearm free flaps can be a valuable reconstructive option for patients with a large defect of the anterior skull base, needing both rigid support and a watertight closure.

癌手术后前颅底缺损的重建具有挑战性。大的缺陷可能需要使用自体游离组织移植。目前，大多数重建使用软组织皮瓣。我们描述了使用前臂桡骨游离皮瓣重建继发于延伸到前颅窝和两个眼眶的恶性副神经节瘤的大缺损。手术切除需要鼻内和经颅入路。我们用游离的前臂桡骨皮瓣重建缺损。我们将骨瓣放在缺损处，放在两侧的眶顶上，然后将软部件缝合到硬脑膜的边缘。椎弓根从开颅处漏斗到准备好的宫颈切开术，并在面动脉和两条卫星静脉上进行微吻合。简要讨论了这种技术的潜在适应症和主要缺点。前臂桡骨游离皮瓣对于前颅底有较大缺损的患者来说是一种有价值的重建选择，需要刚性支撑和防水闭合。