Background: The expanded endonasal approaches to the skull base are modular approaches that arise from the sphenoidal sinus. The reconstructive techniques in these approaches are key to avoid postoperative complications. Available flaps for reconstruction include the pedicled nasoseptal flap, the trans-pterygoid temporoparietal fascia flap, and the posterior pedicle inferior turbinate flap (PPITF), among others. Recently, the middle turbinate flap and nasoseptal flap have been described in a cadaveric study. Objective: The aim of the current study was to compare results of using nasoseptal versus middle turbinate flaps in skull base reconstruction. Patients and methods: This interventional cohort study was carried out on 24 patients in