Too often, a well-intentioned surgeon will perform an osteotomy of the ascending process
of the maxilla in an attempt to shift the nasal pyramid into a central position.
There is a space between the otic capsule and the ascending process
of the palatoquadrate where cranial nerve VII exits the skull posteriorly.
We obtamed a biopsy specimen with a 0[degrees] endoscope by incising the mucosa of the lateral nasal wall over the area of the ascending process of the palatine bone.
One piece of cranial bone was used to reconstruct the medial aspect of the lateral nasal wall in the region of the ascending process of the palatine bone; the other was placed slightly lateral to the first just under the fascial graft that covered the skull base defect.