MINI REVIEW article
Front. Oncol.
Sec. Head and Neck Cancer
Endonasal Flap Reconstruction in Sinonasal Malignancy
Kalpesh Hathi
Christopher J. Chin
Dalhousie University, Halifax, Canada
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Abstract
Sinonasal malignancies are a broad, yet rare, class of head and neck cancers with a poor prognosis. Surgical resection is the mainstay of treatment for the majority of tumours. Resection of sinonasal malignancies may result in cerebrospinal fluid (CSF) leak, meningitis, pneumocephalus, and prolonged nasal crusting if not appropriately reconstructed. The advent of endoscopic sinus surgery (ESS) has transformed the field and allowed for fully endonasal resection of sinonasal malignancies. The Hadad-Bassagasteguy flap, now colloquially known as the nasoseptal flap, has revolutionized endonasal reconstruction. The nasoseptal flap is a robust mucoperichondrial flap pedicled on the posterior septal artery, providing a rich and reliable blood supply. The nasoseptal flap has become the workhorse of anterior skull base reconstruction given its relative ease of harvest, reliability, low donor site morbidity and success: CSF leaks rates have decreased from > 20% to < 5% with the use of the nasoseptal flap. This review thoroughly discusses the history, use, and techniques for the nasoseptal flap.
Summary
Keywords
malignancy, nasoseptal, reconstruction, Sinonasal, Skull Base, Sphenopalatine
Received
29 December 2025
Accepted
19 February 2026
Copyright
© 2026 Hathi and Chin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Kalpesh Hathi; Christopher J. Chin
Disclaimer
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