ObjectiveTo evaluate the application of perforator flaps to the skull base reconstruction of advanced oncological defects.MethodsClinical data of 14 patients received reconstruction of skull base tumor ablation defects with perforator flaps from Oct. 2004 to May 2011 was analyzed retrospectively. There were 14 flaps including 8 deep inferior epigastric artery perforator (DIEA) flaps, 5 anterolateral thigh (ALT) flaps and 1 thoracodorsal artery perforator (TAP) flap. All patients had recurrent advanced neoplasms with previous radiation therapy or surgery history.ResultsThe overall success rate was 93% (13/14). One ALT flap got necrotic. Three patients (20%) had cerebrospinal fluid fistula and 2 of them developed infection of central nervous system. No complications such as wound dehiscence, weakness and hernia were observed in the donor sites.ConclusionsPerforator flaps are new and reliable for reconstruction of advanced oncological skull base defects. With advantages of minimal donor site morbidity, the perforator flap may be one of the preferred choices.