Acta otorrinolaringologica espanola最新文献

{"title":"Diagnostic accuracy of the head pitch test in benign paroxysmal positional vertigo.","authors":"Mayada Elsherif, Alia E L Karaksy, Dalia Eldeeb, Mirhan Eldeeb","doi":"10.1016/j.otoeng.2025.512288","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512288","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The diagnostic accuracy and reliability of the head pitch test in differentiating between different types of BPPV require further investigation. Studying the diagnostic accuracy of the head pitch test in BPPV diagnosis can aid in the development of targeted management strategies for patients presenting with BPPV METHODS: All patients who complained of positional vertigo for seconds underwent complete videonystagmography test using ICS Chartr 200 VNG/ENG system (Otometrics, Denmark) including : spontaneous nystagmus, complete occulomotor test battery, then the head pitch test was performed in two positions: first the patient's head was bent 90 degrees forwards, then 60 degrees backwards for approximately 1 minute each. If nystagmus was observed, its direction was recorded¹. All patients then underwent gold standard tests for positional vertigo including both Dix-Hallpike maneuver and the supine roll tests.</p><p><strong>Results: </strong>The sensitivity (true positive cases) was defined as the head pitch (HPT) test being positive and showing the correct nystagmus for different categories of BPPV. The sensitivity of the experimental HPT was compared to the gold standard tests (100% sensitive) for diagnosis of different categories of vertical canal and lateral canal BPPV. It was highest (100%) for Lateral Cupulolithiasis patients (n = 12) and Anterior canal Canalithiasis (n = 3) and lowest (68%) for Typical Posterior Canalithiasis patients (n = 68).</p><p><strong>Conclusion: </strong>This study supports the addition of the head pitch test in the routine assessment of patients with positional vertigo. As it could shorten the examination time and decrease the repositioning maneuvers which may cause severe autonomic symptoms.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512288"},"PeriodicalIF":0.0,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges of central compartment atopic disease in type-2 chronic rhinosinusitis.","authors":"Ramón Moreno Luna, Julissa Vizcarra Melgar, Daniel Martín Jiménez, Meritxell Clari Comes, Pedro Infante Cossio, Serafín Sánchez Gómez","doi":"10.1016/j.otoeng.2025.512290","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512290","url":null,"abstract":"<p><strong>Background: </strong>Central compartment atopic disease (CCAD) is an emerging phenotype of type-2 chronic rhinosinusitis (CRS), characterized by inflammation involving the central nasal structures. The absence of standardized diagnostic criteria has hindered its recognition. This study aims to describe the first European cohort of CCAD patients and compare its features with previously published international data.</p><p><strong>Materials and methods: </strong>A retrospective observational study was conducted including adult patients diagnosed with CCAD at a tertiary rhinology unit (2021-2024), based on predefined endoscopic and radiologic criteria. Demographic, clinical, exploratory, analytical and quality-of-life data were collected. Descriptive statistics were used to characterize the baseline profile of the study population.</p><p><strong>Results: </strong>The cohort of 93 CCAD patients was predominantly male (65.6%) with a mean age of 48.7 ± 12.2 years. The baseline SNOT-22 score averaged 61.5 ± 24.3, with marked olfactory impairment. Asthma and N-ERD were reported in 40.9% and 7.5% of cases, respectively; allergic sensitization was confirmed in 60.2%. The mean endoscopic scores were 4.0 ± 2.2 for the nasal polyp score and 7.5 ± 2.5 for the modified Lund-Kennedy scale, while the mean CT-scan score was 11.7 ± 3.8. Blood eosinophilia >150 cells/μL was present in 77.4% of patients, and tissue eosinophil counts averaged 49.9 ± 43.8 eosinophils per high-power field.</p><p><strong>Conclusion: </strong>This study reinforces CCAD as a localized type-2 CRS phenotype with a distinctive atopic signature. Findings underscore the need for standardized diagnostic criteria to improve its recognition and guide more personalized therapeutic strategies.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512290"},"PeriodicalIF":0.0,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-life outcomes of benralizumab treatment in chronic rhinosinusitis with nasal polyps: The BenREALizumab Study.","authors":"Juan Maza-Solano, Vicente Merino-Bohórquez, Ana Gómez-Bastero, Julio Delgado-Romero, Serafín Sánchez-Gomez","doi":"10.1016/j.otoeng.2025.512291","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512291","url":null,"abstract":"<p><p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease with a significant impact on quality of life. Benralizumab has shown efficacy in severe eosinophilic asthma, but there is limited evidence for CRSwNP. A prospective observational study was conducted in a tertiary hospital with six adults with severe CRSwNP, according to EPOS2020 criteria, treated for 52 weeks. All had multiple surgeries (mean 3.3) and high cumulative exposure to systemic corticosteroids. Initially, they presented a high symptom and endoscopic burden (SNOT-22: 72; NPS: 5.2). After 16 and 52 weeks, significant improvements were observed in SNOT-22 (40.3 and 28.8), NPS (4.3 and 2.7), corticosteroid use, and complete eosinophil depletion. VAS scores improved, especially in smell, rhinorrhea, and general condition. No significant adverse events occurred. These preliminary results suggest that benralizumab may be effective in CRSwNP without associated asthma, although larger controlled studies are needed.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512291"},"PeriodicalIF":0.0,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Cochlear Implants on Cognitive Performance During Aging.","authors":"Fatima Ezzahra Rizkou, Youssef Lakhdar, Omar Oulghoul, Chehbouni Mohammed, Othmane Benhoummad, Youssef Rochdi, Abdelaziz Raji","doi":"10.1016/j.otoeng.2025.512289","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512289","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the impact of cochlear implantation on cognitive function in older adults, focusing on executive function, processing speed, and memory.</p><p><strong>Methods: </strong>A prospective observational study was conducted on 15 older adults (mean age: 72.4 years) who underwent cochlear implantation at the ENT and Head and Neck Surgery Department. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT-A and TMT-B) pre- and post-implantation (6 and 12 months). Results were compared using statistical analyses, and correlations between cognitive improvement and speech perception outcomes were examined.</p><p><strong>Results: </strong>Cognitive function significantly improved post-implantation, with MMSE scores increasing from 22.93 ± 3.2 at baseline to 24.6 ± 2.9 at 12 months (p < 0.05). TMT-A and TMT-B scores also improved significantly (p < 0.05), indicating enhanced executive function and processing speed. A moderate correlation (r = 0.52, p = 0.04) was observed between cognitive improvement and speech perception.</p><p><strong>Conclusion: </strong>These findings support the hypothesis that cochlear implantation in older adults positively impacts cognitive function. This study adds to the growing body of evidence suggesting that auditory rehabilitation may help mitigate cognitive decline in aging populations.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512289"},"PeriodicalIF":0.0,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coblation versus suction Diathermy in Endoscopic Pediatric Adenoidectomy: Randomized clinical trial.","authors":"Abobakr Mohammed Elbakry, Ahmed Nabil Selim, Alaa Abdelwahab Elderawy, Abdallah Mahmoud Gad","doi":"10.1016/j.otoeng.2025.512287","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512287","url":null,"abstract":"<p><strong>Objectives: </strong>the aim of the study is comparing endoscopic Coblation adenoidectomy and suction diathermy in terms of surgical duration, intraoperative blood loss, and postoperative complications such as foul odor, neck pain, and secondary bleeding, as well as patient recovery.</p><p><strong>Patients and methods: </strong>prospective randomized double blinded controlled trial involving 210 patients who presented with adenoid hypertrophy. Randomization was done in two groups group A including 105 patients who underwent Endoscopic adenoidectomy by suction diathermy, Group B including 105 patients who underwent endoscopic adenoidectomy by Coblation technique. Patients were compared regarding intraoperative blood loss and operative time and postoperative bleeding, postoperative neck pain, and halitosis.</p><p><strong>Results: </strong>When comparing the two groups, Group B had notably longer surgeries but experienced less pain after the operation, recovered more quickly, and had a lower chance of bad breath. there was no significant difference between both the groups regarding intraoperative blood loss CONCLUSION: both techniques are effective in management of adenoid hypertrophy, but results showed Endoscopic adenoidectomy with Coblation is favored over suction diathermy due to better endoscopic evaluation and postoperative outcomes.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512287"},"PeriodicalIF":0.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of the Spanish versions of the Chronic otitis media questionnaire-12 (COMQ-12) and Chronic otitis media benefit inventory (COMBI) in patients and controls in our environment.","authors":"Alberto Codina, Berta Alegre, Elena Hernández-Montero, Jorge Vega, Miguel Caballero-Borrego, Francisco Larrosa","doi":"10.1016/j.otoeng.2025.512273","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512273","url":null,"abstract":"<p><strong>Background and objective: </strong>The Chronic Otitis Media Questionnaire-12 (COMQ-12) and the Chronic Otitis Media Benefits Inventory (COMBI) seek to assess the quality of life related to chronic otitis media or its surgical treatment. The objective of this study was to determine and evaluate the scores of the Spanish versions of the COMQ-12 and the COMBI.</p><p><strong>Materials and methods: </strong>Multicenter retrospective study. Mean scores of the Spanish versions (COMQ-12-Spa and COMBI-Spa) were compared in consecutive adult patients diagnosed with chronic otitis media (COM), with or without cholesteatoma, undergoing tympanoplasty with and/or mastoidectomy and in a separate cohort of unaffected adults.</p><p><strong>Results: </strong>120 patients and 60 unnaffected adults completed the study. The mean score of the COMQ-12-Spa in patients with COM and in healthy adults was 22.95 ± 11.72 and 0.8 ± 1.3 respectively (p < 0.0001). COMQ-12-Spa did not discriminate between COM without (21.9 ± 10.45) and with cholesteatoma (23.82 ± 9.53) (P > 0.05). COMBI-Spa showed a mean postoperative score of 46.02 ± 9.08 and was not able to discriminate between tympanoplasty without mastoidectomy (48.01 ± 8.09) and mastoidectomy (45.32 ± 10.03) (P > 0.05).</p><p><strong>Conclusions: </strong>The COMQ-12-Spa and the COMBI-Spa allow the pre- and post-intervention evaluation of the subjective severity of COM in adult patients in our setting, so their use is recommended.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512273"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of the Cinnarizine/Dimenhydrinate Combination versus Betahistine in the Treatment of Vertigo: A Systematic Literature Review.","authors":"David Martín-Enguix, Niceto Gómez Gabaldón, Francisco J Amaro-Gahete","doi":"10.1016/j.otoeng.2025.512274","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512274","url":null,"abstract":"<p><p>Vertigo is a frequent reason for medical consultation and may result from a wide range of aetiologies. Betahistine and the fixed low-dose combination of cinnarizine 20 mg and dimenhydrinate 40 mg are commonly used therapeutic options, each with distinct antivertigo profiles. This systematic review, conducted in accordance with the PRISMA guidelines, aims to compare the efficacy and safety of these two treatments in patients with vertigo of various origins. A comprehensive search was conducted in PubMed, Cochrane Library, Google Scholar, and ClinicalTrials.gov, with no restrictions on language or publication date. Eligible studies included clinical trials and meta-analyses comparing the fixed low-dose combination (20 mg/40 mg) versus betahistine (12 or 16 mg), assessing efficacy through the Mean Vertigo Score (MVS) and safety based on the incidence of adverse events (AEs). The RoB 2 and ROBIS tools were used to evaluate the risk of bias. A total of nine studies were identified (six clinical trials and three meta-analyses). In five of the six clinical trials, the fixed low-dose combination significantly reduced MVS compared with betahistine at weeks 1 and/or 4 (p < 0.05); these findings were corroborated by the three meta-analyses. Regarding safety, both treatments were well tolerated, with no serious AEs reported and a generally lower incidence observed in the fixed low-dose combination group. Overall, the fixed low-dose combination demonstrated superior clinical efficacy from the first week of treatment, along with a more favourable tolerability and safety profile. These results support its preferential use in the management of acute vestibular syndrome.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512274"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the self-assessment questionnaire for patients with unilateral vocal cord paralysis (PVU-HI-10) in Spanish.","authors":"Rosa Hernández-Sandemetrio, Natsuki Oishi, Isabel López, Cristina Rodríguez-Prado, Isabel García-Lopez, Enrique Zapater","doi":"10.1016/j.otoeng.2025.512271","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512271","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Unilateral vocal cord paralysis (UVCP) is a condition that directly affects laryngeal functions. While most cases have an organic cause, idiopathic cases have also been described. Patients with UVCP often experience symptoms that impact not only their vocal abilities but also their nutritional and social well-being. Our primary objective is to validate a self-assessment questionnaire for patients with UVCP and unilateral vocal immobility, incorporating questions that cover all possible symptoms of this condition, adapted to the Spanish spoken in Spain.</p><p><strong>Methodology: </strong>This is a prospective observational study using the PVU-HI-10 questionnaire, which assesses the functional, physical, and emotional impact of UVCP-related symptoms. For validation, we statistically evaluated test-retest reliability, item-total correlation, internal consistency, concurrent validity, and discriminative validity, with sensitivity and specificity analysis. A total of 62 subjects participated: 33 patients (case group) and 29 healthy individuals (control group). All participants completed the PVU-HI-10 questionnaire twice, with a three-week interval between assessments and no treatment administered between them. The maximum phonation time (MPT) was used as the objective reference measure.</p><p><strong>Results: </strong>The test-retest reliability was high, with an intraclass correlation coefficient (ICC) of 0.95. Internal consistency, measured using McDonald's omega coefficient, was 0.91 for the case group and 0.94 for the control group. The correlation between MPT and questionnaire scores was strong and inversely related (-0.61 and -0.67, respectively). Discriminative validity was demonstrated using the ROC curve, with a cutoff point of 12.1, yielding a sensitivity of 82% and a specificity of 93.1%.</p><p><strong>Conclusions: </strong>In the management of unilateral vocal immobility, it is essential to consider the degree of disability caused by the symptoms. The PVU-HI-10 is a condition-specific questionnaire that has shown high reliability and validity. It is a brief, simple test that provides a numerical result, allowing for the quantification and comparison of treatment outcomes. This makes it a useful tool in the evaluation protocol for patients with unilateral vocal paralysis in Spanish-speaking populations.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512271"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardisation of Sinonasal Anatomical Terminology in Spanish: An Expert Consensus.","authors":"Juan Ramón Gras-Cabrerizo, Juan Carlos Villatoro-Sologaistoa, Maria Casasayas-Plass, María Martel-Martín, Carolina Alfonso-Carrillo, Miguel Armengot-Carceller, María Sandra Domínguez-Sosa, Rafael Fernandez-Liesa, Ainhoa García-Lliberós, María Gil-Melcón, Xavier González-Compta, Fernando López-Álvarez, Mauricio López-Chacón, David Lobo-Duro, Nieves Mata-Castro, Irene Monjas-Cánovas, Ramon Moreno-Luna, Laura Pardo-Muñoz, Mayte Pinilla-Urraca, Alfonso Santamaría-Gadea, Jaime Santos-Pérez, Francisco Valcárcel-Martín, José Miguel Villacampa-Aubáf, Alfonso Del Cuvillo-Bernal, Serafín Sánchez-Gómez, Humbert Massegur-Solench, Manuel Bernal-Sprekelsen, Isam Alobid","doi":"10.1016/j.otoeng.2025.512275","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512275","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in endonasal endoscopic surgery have highlighted the need to unify and adapt sinonasal anatomical terminology. This study aims to translate and validate the anatomical terms proposed by the European Rhinologic Society into Spanish, in order to facilitate their use and dissemination.</p><p><strong>Methods: </strong>A Delphi methodology was employed, involving 24 nationally recognized rhinologists with extensive experience in endoscopic surgery. In the first round, Spanish equivalents were proposed for the 121 concepts included in the EPOS (European Position Paper on the Anatomical Terminology) supplement. In the second round, each participant selected a single preferred term among the most voted options. Finally, a panel of seven national experts reviewed and approved the definitive terms, including additional concepts not previously addressed in reference documents.</p><p><strong>Results: </strong>In 61% (73/121) of the concepts, the expert panel ratified the term most voted by the group of rhinologists. In 31% (38/121), the most voted term was modified, and in 8% (10/121), a final decision was made in the event of a tie. The use of eponyms and latinisms was avoided whenever possible. The terminology selected aimed to accurately reflect the corresponding anatomical concepts. Moreover, relevant terms not included in the EPOS consensus documents or the Anatomical Terminology were incorporated.</p><p><strong>Conclusion: </strong>The adaptation and validation of sinonasal anatomical terminology into Spanish enhances international communication and contributes to improving clinical practice in rhinology.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512275"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pericranial flap for endoscopic reconstruction of skull base defects (\"money box approach\"): Experience at our center and literature review.","authors":"Fabio Fernández-Mateos, Laura Yeguas-Ramírez, Victor Rodríguez-Berrocal, Franklin Mariño-Sánchez, Alfonso Santamaría-Gadea","doi":"10.1016/j.otoeng.2025.512272","DOIUrl":"https://doi.org/10.1016/j.otoeng.2025.512272","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;One of the main challenges in the development of endoscopic surgical techniques for the treatment of nasosinusal neoplasms and skull base pathology is the reconstruction of the defects resulting from these procedures. Endonasal flaps (with the nasoseptal flap as the primary option) are typically the first-line choice for managing such defects. Unfortunately, in some cases, these flaps are either unavailable or insufficient to adequately repair the defect. In such scenarios, the pericranial flap can be employed with excellent outcomes. However, large case series describing the endoscopic use of the pericranial flap for skull base reconstruction are lacking in the literature, and its reconstructive limits, indications, and outcomes remain to be clearly defined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We present a descriptive observational study involving a sample of 7 patients who, between 2019 and 2025, underwent surgery at our center in which a pericranial flap was used for skull base defect reconstruction. The surgical technique employed includes an endonasal approach with a Draf III procedure, combined with an external approach allowing flap harvesting and frontal sinus opening for its insertion into the nasal cavity. A bicoronal incision is made in the scalp, the skin and galea aponeurotica are elevated anteriorly up to 1 cm above the orbital rim. The flap is then elevated from the calvarium and introduced through an external osteotomy in the superior region of the frontal sinus, identified via endoscopic transillumination (\"money box approach\"). This allows the flap to be guided into the nasal cavity and positioned to cover the existing defect, with both intracranial and extracranial coverage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eighty-five percent of patients were male, with a mean age at surgery of 62.5 years. In 85% of cases, the flap was required for primary reconstruction of a defect following extensive oncologic resection, with adenocarcinoma being the most frequent histology and the transcribriform approach the most commonly used. The mean anteroposterior diameter of the defect was 4.06 ± 1.8 cm, and the mean latero-lateral diameter was 1.86 ± 0.44 cm, resulting in a mean defect area of 7.53 cm². The median postoperative hospital stay was 10 days. Postoperative complications occurred in two cases, but only one required surgical revision due to a cerebrospinal fluid leak, which was resolved by repositioning the flap.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;When endonasal flaps are not viable, the pericranial flap, due to its size, robustness, and versatility, is a highly effective surgical tool for the reconstruction of complex defects throughout the entire ventral skull base. Although most experience to date relates to anterior approaches, its use can also be considered for posterior approaches (such as transclival) with favorable outcomes. For this reason, it is recommended as the reconstructive option o","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512272"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}