الفهرس 
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Abstract
This is a two centers prospective study that assesses 110 cranial base reconstructions after pure endonasal endoscopic resection of 100 skull base lesions. The age range was 1-69 years, and the mean age was 39.49. Males were 55% of them and 45% were females. Headache was the most common presentation (80%). Pituitary adenomas were the commonest pathology (65%). Sites of defect included sellar defects (60%), sellar with suprasellar extension (14%), cribriform defects (10 %), and others included Ethmoidal, Carotid, Planum & ethmoidal, Clival defect, Planum, and Extended defects (21%). The mean size of the defects is 2.6 cm2± 1.6 with defect size ≥ 2 cm2 account for 66% of the defects. 15% of patients had a history of previous skull base surgery and 5% has a history of radiotherapy or chemotherapy. Based on the intraoperative CSF flow and availability of the local mucosal covering(flap\graft) the patients were classified into 4 levels with 4 types of skull base repairs: Level 1: No intraoperative CSF leak with extensive tumor dissection, Repaired by type I repair which was a single layer of an overlay mucosa(graft\flap) and included 23 repairs. level 2: Low flow CSF leak, repaired by type II-III repair, which were Multilayer repair graft with/without mucosal covering ± Gasket seal technique ± Platelet concentrate and included 30 repairs. - level 3: High flow CSF leak without the availability of a vascularized flap, repaired by type II-III repair which were Multilayer repair graft with/without mucosal covering ± Gasket seal technique ± Platelet concentrate, and included 6 repairs